The rich, the young, and the unhealthy — these are the people who believe that they're not getting a fair return on the dollars they spend on health care.
PricewaterhouseCoopers wanted to find out just how unhappy consumers were with the current health care payment system in the U.S. Going into the survey ("Money Matters: Billing and payment for a New Health Economy") with the knowledge that health care billing is at least a decade behind the billing practices followed by every other industry, PwC put a series of questions to some 1,000 U.S. adults designed to dig deeper into the general dissatisfaction with health care payment systems.
What emerged from the research was perhaps a bit unexpected. For instance, the wealthiest people in the survey — those making six-figure salaries—were by far the most unhappy with the health care payments system. The youngest respondents — those oft-studied millennials — were the most likely to go nose-to-nose with a billing department over a bill. And those who required more medical attention than others in the study — in other words, the people with the most experience trying to figure out bills and charges — were also quite dissatisfied with the system.
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Among the major findings:
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Patients and affluent consumers are most dissatisfied with the health care billing and payment system. For example, one in two consumers in poor or fair health— the greatest utilizers of the system — rated hospitals poorly on price transparency and affordability.
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The affluent were almost twice as likely as those in the general population to say that their health insurance isn't affordable.
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The affluent were twice as likely as the general population to say that their payment experience had damaged their view of their insurer.
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The affluent were 10 percent more likely than the general population to say they doubted the accuracy of their bills.
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Respondents who were between 25 and 34 years of age were far more likely to say they had asked for a discount, asked for cheaper drugs, had asked for payment assistance, and had requested a less expensive specialist than any other age group.
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Cost-conscious millennials are more likely than the general population to judge health care organizations based on their billing practices. They also are more likely to challenge medical bills, search for better deals, and make value-based decisions.
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Consumers and new entrants are beginning to circumvent the claims-based health care payment system, especially in primary care services and chronic disease management.
If those trying to collect medical bills from consumers could get their payment system act together, they'd probably get paid more often and a lot faster, PwC opined.
Hospitals, physician practices, and other health care providers who successfully transition might collect more of their patients' bills, and they might collect them more quickly. They might expect to be able to better manage cash flow, reduce reserves for bad debt, and minimize administrative costs.
The study is available through PwC's website. The survey and the report based on the responses were created as a roadmap for modernizing, streamlining, and simplifying the health care industry's payment system.
"As consumers shoulder higher deductibles and cost-sharing, they increasingly are being forced to navigate the complex health care billing and payment system on their own. Streamlined payment could be a differentiator for health systems, insurers, new entrants and others, especially for services that can be commoditized," PwC said in the report. "Technology will not completely solve the billing and payments system's issues. Complexity must be removed from the system. The entire structure needs to be rethought, considering differences in consumers' needs. Digital can do its magic once the streamlining is done."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
