Patient payment responsibility increases 11% in 2017

March 7, 2018

A new TransUnion Healthcare analysis revealed that patients experienced an 11% increase in average out-of-pocket costs during 2017, rising from $1,630 in Q4 2016 to $1,813 in Q4 2017. The analysis also revealed that in 2017, on average, 49% of patient out-of-pocket costs per healthcare visit were below $500; 39% were $501-$1,000; and 12% were more than $1,000.

The results were released March 5 at the 2018 HIMSS Conference, where TransUnion’s Jonathan Wiik is presenting findings from his book,  “Healthcare Revolution: The Patient Is the New Payer.” The book explores how the financing and delivery of healthcare has been impacted by major shifts in coverage, payments and legislation.

“Increasing healthcare costs and patient responsibility is a continuing trend that does not seem to be slowing anytime in the near future,” said Wiik, principal of healthcare strategy at TransUnion Healthcare. “Given the increased payment responsibility, being able to determine a patients’ ability to pay is increasingly important for hospitals. In order to allow patients to focus on getting the care they need, healthcare providers need processes and tools in place to help patients meet their financial obligations and to establish funding mechanisms that will benefit both the patient and provider.”

The need is supported by a 2016 Federal Reserve Economic Report of household income, which found 35% of adults would be unable to make all of their other bill payments in full if faced with a $400 emergency.

TransUnion Healthcare’s analysis also found that costs for major procedures are not abating. Medical specialties with the highest out-of-pocket cost estimates for patients, included: Orthopedics ($1,663), Plastic Surgery ($1,566), Urology ($1,415) and Neurology ($1,241), all of which are above the $1,000 average across all specialties in Q4 2017.

With millions of dollars of unpaid medical bills, many hospitals are instituting processes to protect their revenue. TransUnion Healthcare’s insurance discovery solutions have helped hospitals, health systems and physician offices recover insurance payments, which previously would have been categorized as bad debt or charity care.

Transunion Healthcare also works with hospitals to stratify their bad-debt portfolio through its Financial Clearinghouse suite of solutions, which determine charity eligibility, ability and likelihood (propensity) to pay.

Transunion has the full release