business

Fewer patients struggle with medical debt

People across various demographic categories reported improvement in their ability to pay for care.

By Sue Ter Maat — Posted June 18, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

An improving economy, less expensive preventive care and reduced use of health services all appear to be contributing to fewer people reporting trouble paying their medical bills.

A Centers for Disease Control and Prevention report released in June looked at medical debt from June 2011 to June 2012 (link). It found that the percentage of people younger than 65 in families having problems paying medical bills dropped from 21.7% to 20.3% over that period.

The survey asked respondents, “In the past 12 months, did you/anyone in the family have problems paying or were unable to pay any medical bills?” That included bills for doctors, hospitals, therapists, medication, equipment, nursing homes or home care.

The percentage of men saying they were having issues with medical debt dropped from 20.8% to 19.7%, while women dropped from 22.6% to 20.8%, according to the CDC report, which surveyed about 155,000 people.

The report also indicated that people who said they had trouble with medical debt decreased across major age groups. Children ages 0 to 17 in families having trouble paying their bills dropped from 23.7% to 21.8%, and for ages 18 to 64, those in families having debt issues went from 20.9% to 19.7%.

It was also true for the poor, defined as below the U.S. Census Bureau poverty threshold . The percentage of people in that group who had trouble paying medical bills dropped from 32.8% to 30.3%.

But the percentage of uninsured with medical debt issues increased over that period, from 35.7% to 36.3%, according to the report. Those with private insurance who said they had trouble paying medical bills dropped from 15.7% to 14.0%, and those with public insurance declined from 28.0% to 25.6%.

What’s behind the decline

The CDC survey is the most extensive of numerous reports that have found fewer patients reporting no trouble with — or at least no increase in — medical debt, or feeling like cost is less a barrier to care than it once had been.

It’s possible that one factor behind the CDC’s reported decline in medical debt issues is that some are avoiding doctors and hospitals, if they can, to avoid running up debt in the first place, said Shana Alex Lavarreda, PhD, director of health insurance studies at the UCLA Center for Health Policy Research.

However, other reasons for the decline are more positive. An improving economy may be adding to insured enrollees’ ability to pay their bills when they are incurred, she said. Meanwhile, expansion of coverage under the Affordable Care Act also is having an effect, she said.

Many provisions of the ACA aren’t fully in place until 2014, but provisions such as allowing children 26 or younger to stay on their parents’ health plans and a requirement that insurers charge no out-of-pocket costs for certain preventive procedures have been cited in other studies looking at Americans’ increasing ability to pay for health care.

“The Affordable Care Act has made preventive services available to nearly everyone at no charge,” Lavarreda wrote in an e-mail. “This would reduce the debt incurred for tests like colonoscopies, which, prior to the ACA, could potentially cost thousands of dollars depending on the complication that might arise during the procedure.”

Most medical debt is less than $4,000, based on data from the California Health Interview Survey, the nation’s largest state health survey, Lavarreda wrote.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story