Help! I'm Buried In Debt

Patients Struggling to Pay Low-Balance Medical Bills

Most patients do not pay off the full balance.

Did you know that at least 68% of patients with medical bills less than $500 do not pay off the full balance?

That’s according to the most recent data collected by TransUnion Healthcare. The 2017 study also predicts that by 2020, the percentage of patients who fail to pay their bills in full will rise to a whopping 95%.

What’s Going On?

Medical Billing Statement

“There are many reasons why more patients are struggling to make their healthcare payments in full,” says Jonathan Wiik, author of the book “Healthcare Revolution: The Patient is the New Payer.” Wiik is the principal for healthcare revenue cycle management at TransUnion. But the primary reasons, Wiik says, are higher deductibles and the increase in patient responsibility.

The data seems to bear this out:

  • According to the National Center for Health Statistics, the percentage of persons under age 65 enrolled in a high-deductible health plan (HDHP) increased to 47% in 2018. (The IRS defines an HDHP as any plan with a deductible of at least $1,350 for an individual or $2,700 for a family.)
  • Patients with commercial insurance plans experienced a 67% increase in their financial responsibility over five years. In 2017 alone, average out-of-pocket costs increased 11 percent — from $1,630 to $1,813.

Young People Struggling Most

And it’s not the older folks who are struggling to pay their medical bills.

In fact, a 2018 study published in the journal Health Affairs found that, although healthcare spending increases as people get older, medical collections decrease substantially with age. People in their late 20s are nearly three times as likely to have a medical bill sent to collections than those in their late 60s, the study found.

Benedic Ippolito, an economist with the think tank American Enterprise Institute was one of the researchers for the 2018 study. He speculates that patients in their 20s probably earn less and have less savings than their older counterparts. They’re also more likely to be uninsured.

Other Findings

The TransUnion study also found that, in 2016:

  • The percentage of patients who made partial payments toward their hospital bills declined dramatically from almost 90% to 77%.
  • 99% of hospital bills totaling $3,000 or more were not paid in full.
  • 85% of hospital bills totaling $500 to $1,000 were not paid in full.

What’s the Answer?

As a medical provider, what can you do to help your patients pay their healthcare bills? Here are a few suggestions:

  • Be willing to negotiate. If you know a patient is having financial difficulties, consider reducing the total bill or negotiate a payment plan.
  • Refer them to assisting agencies. Maintain a database of local charities or other assistance organizations who can help your customers with their medical bills. Also, refer them to food pantries and utility assistance programs—they’ll know you care, and it could free up some of their resources to pay their medical bills.
  • Offer a discount healthcare program to your self-pay patients. Contact the Consumer Healthcare Alliance to learn how.
Medical Debt Info Graphic



TransUnion Healthcare

RevCycle Intelligence

CBS News

Health Affairs

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