Health Care Costs

High-Deductible Plans Are a Growing Problem for Both Patients and Hospitals

The enrollment in high-deductible health insurance plans is becoming more and more commonplace as employers are searching for ways to curb their ever increasing spend on healthcare benefits for their employees.  Employees covered under high-deductible health plans find themselves spending more out of pocket on healthcare than ever before as more of the financial responsibility is shifted to them.

A recently released Kaiser survey reported that in 2006 only 4% of employees in employer sponsored health benefit plans were enrolled in high-deductible plans where today 20% are enrolled in these plans.  That is a significant increase.  The launch of the Affordable Care Act in 2014 is expected to further raise the number of enrollees in high-deductible plans.

The minimum deductible of $1250 for an individual or $2500 for a family is required as of 2013 to be designated as high-deductible health plan however the average deductible for a family is between $5000 to $10,000 dollars.  A major illness or the need for expensive surgery can create a bill too large for the employee to afford when deductibles of this size must be reached before the insurance begins to pay for even a percentage of the care.

We get calls every day from individuals who are insured, but they cannot afford the bills they are receiving from the hospital and wondering what options are available to them.

On the flip side, hospitals are experiencing difficulty collecting from patients with high-deductible plans who sometimes find themselves unable to pay their hospital bill.  This is a growing concern for all hospitals, but can be a real issue for hospitals that do not have enough cash flow to handle patient bad debt.

One article we read recently used a small, rural hospital in Florida as an example.  The CFO pointed out the hardship the hospital was facing paying their bills each month.  It is expensive to run a hospital and a real challenge when care has been given, but the hospital cannot collect balances from their patients.

Providers can utilize programs offered by many insurers that track a patient’s deductible throughout the year.  The patient can then be informed what their out of pocket expenses will be up-front.  This can help the collection process opposed to relying solely on billing after care has been given.

However, a study released this year by Health Affairs reports a concerning trend.  Many Americans enrolled in these high-deductible plans, particularly those with low socioeconomic status, are putting off much needed healthcare.  This can lead to increased illnesses as well as increased hospitalization.   The authors of this report suggest that policy makers and employers should not only better educate their employees on the coverage their plans offer, but also consider offering a means-based deductible plan.


Links to articles on this topic:

2013 Employer Health Benefits Survey
The Kaiser Family Foundation
August 20, 2013

More Employee Responsibility, More Unpaid Bills? The Rise of High-Deductible Health Plans and What it Means for Hospitals
By Helen Adamopoulos
Becker’s Hospital Review
September 26, 2013!


More High-Deductible Plan Members Can’t Pay Hospital Bills
By Jay Hancock
Kaiser Health News
August 12, 2013

Low-Socioeconomic-Status Enrollees In High-Deductible Plans Reduced High-Severity Emergency Care
By J. Frank Wharam, Fang Zhang, Bruce E. Landon, Stephen B. Soumerai, and Dennis Ross-Degnan
Health Affairs
August 2013