News: Out-of-pocket costs rose 12% in 2018, study finds

CDI Strategies - Volume 13, Issue 28

Out-of-pocket costs rose across all specialty care settings in 2018, according to a TransUnion Healthcare study released at the 2019 Healthcare Financial Management Association Conference.

Overall out-of-pocket costs rose 12% year-over-year, with inpatient costs jumping more than $600, outpatient costs increasing nearly $200, and emergency department costs rising $40 compared to 2017, HealthLeaders Media reported. And nearly 60% of patients reported having an average out-of-pocket expense between $500 and $1,000 in 2018, a 39% increase year-over-year. 

Dave Wojczynski, president of TransUnion Healthcare, attributed the increases to a growing shift of payment responsibility from payers to patients in recent years.

"As a result, patients are now making decisions about where they receive care based on costs – not just the quality of care they may receive," Wojczynski said in a statement. "This means price transparency is critical for healthcare providers who are not only competing for patients, but also want to secure timely payments from them.”

Though CMS has mandated that hospitals post their price lists for potential patients to access, early efforts got off to a slow start in 2019. Hospitals have repeatedly cited that the price lists wouldn’t be helpful for patients due to differences in payer coverage and contract rates.

The study also found that, while the number of patients with large out-of-pocket costs rose in 2018, the number of patients with smaller out-of-pocket costs decreased by 13% compared to 2017, according to HealthLeaders Media.

In addition to the high out-of-pocket costs facing patients, TransUnion cited other studies that found patients struggled to routinely make payments on healthcare expenses and dealt with increased rates of claims denials from their insurers.

The study concluded that providers should focus on revenue protection strategies in order to recoup as many outstanding reimbursements as possible.

Editor’s note: This article originally appeared in HealthLeaders Media. To read the full study, click here. To read more about early price transparency efforts, click here.

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