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Physicians Advocacy Institute

PAI-NORC survey shows high deductible health plans are a barrier to needed care

A survey of independent physicians from the Physicians Advocacy Institute (PAI), conducted by NORC at the University of Chicago, shows the challenges in patient care caused by high-deductible health plans.

Before the COVID-19 pandemic hit the United States, patients’ large and growing share of out-of-pocket healthcare costs posed challenges for individuals, families, and independent physicians. When the epidemic became a pandemic, the federal government and certain insurance companies acted quickly to make coronavirus-related care widely accessible by ensuring it was affordable to everyone who needed it.

Waiving patients’ deductibles during a time of crisis spotlighted the flaws inherent in high-deductible health plans (HDHPs). They force patients to take on all of the up-front financial responsibility that used to be covered by health insurance companies. Now millions of people must cover thousands of dollars in healthcare costs entirely out of their own pockets before their insurance kicks in. Those who can’t afford to meet their increasingly high deductible delay or forego needed office visits, procedures, and prescription drugs, as the survey shows.

The survey offers insight into how HDHPs impact patients by making cost the primary consideration in treatment decisions. It also explores physician readiness to have health cost discussions with patients regarding their health plan, and the financial risks independent physician practices face when patients cannot afford to pay the medical bills that insurance companies used to pay up front.

Key findings include:

  • 79 percent of physicians believe that high health insurance deductibles are a key driver of patients’ cost concerns.
  • 80 percent of physicians believe their patients often or sometimes refuse or delay care due to cost concerns.
  • More than half of physicians report that patient delay of care caused capacity or schedule issues for their practice.
  • 77 percent of providers say it takes more than a month to receive any payment.
  • Three out of four physicians say they don’t have most of the information they need in order to have cost of care discussions with patients
  • Most physicians say their office staff spends more than 300 hours per year educating patients on their coverage.

Download the study and press release.