A Kaiser Family Foundation survey revealed that despite beneficiary satisfaction, employer-sponsored plans yield high patient costs.
Employer-sponsored health plans typically yield high beneficiary satisfaction, although many individuals enrolled on these plans experience numerous financial obstacles, according to a new poll published by the Kaiser Family Foundation.
The survey of nearly 1,500 patients enrolled on an employer-sponsored plan revealed that most patients like their insurance. Sixty eight percent of respondents gave their health plans an A or B grade, based on a traditional grading scale. Only 5 percent gave their plans a D and only 1 percent gave plans a failing grade.
But those responses change when looking at those enrolled in high-deductible health plans and therefore incur higher out-of-pocket costs, the researchers pointed out. Only 57 percent of those in an HDHP gave their health plans an A or B grade, while 8 percent gave a D or F. Of those in the highest deductible bracket, 13 percent gave a D grade.
This dissatisfaction likely stems from the high cost burden patients bear, the researchers said.
Four in ten respondents said they have problems paying their medical bills, difficulty affording premiums, or issues with high out-of-pocket healthcare costs. Another half of respondents said they or someone in their household has skipped or postponed medical attention or prescription treatments because of high costs.
A total of 17 percent of respondents said they have had to make what they say are difficult sacrifices to pay for health or insurance costs.
Affordability is a bigger issue for patients in higher deductible plans, the survey authors added. Most patients in HDHPs do not have enough savings to cover the full amount of their deductible. Said otherwise, these patients do not have enough savings to cover their deductible if they experienced a serious and costly medical emergency.
Beneficiaries with chronic illnesses, or who have someone with a chronic illness in their household, also fare poorly, the survey showed.
A total of 54 percent of those with employer-sponsored healthcare said someone in their household has a chronic condition such as hypertension, asthma, diabetes, or a serious mental health condition.
About half of this group said they have difficulty paying for out-of-pocket healthcare bills or premiums, compared to only about 30 percent of those on HDHPs but who do not have a chronic condition.
These costs have had negative side effects, the survey pointed out. Three-quarters of those in the highest deductible health plans said someone in their household has skipped or delayed medical care because of the cost of their chronic illness.
As high healthcare costs continue to burden health plan beneficiaries, their priorities around selecting a health plan are changing. In 2003, most individuals valued coverage-related factors – such as which providers are in-network or which benefits are included – the most when selecting a health plan. These factors took precedent over cost-related factors.
Now, six in ten patients in an employer-sponsored plan said they prioritized premium, deductible, and co-pay costs when selecting a health plan. Only about one-quarter of respondents prioritized coverage-related factors.
To combat high out-of-pocket costs, beneficiaries are turning into conscious health consumers. Seven in ten respondents said they have engaged in a price conscious behavior in the past year. Just under half (47 percent) said they have asked for a generic drug instead of a name brand, which was the most common cost-cutting strategy.
Other strategies have included price shopping (17 percent) and price negotiation (9 percent).
Some industry leaders say this is evidence that HDHPs are doing their jobs. HDHPs were supposed to lead patients to adopt cost-cutting strategies by introducing the potential for high medical bills.
But the effectiveness of those strategies has been mixed, the researchers said.
Those in a high-deductible plan are no more likely to adopt cost-cutting strategies than those in a low-deductible plan. Those results are more pronounced when looking at patients in HDHPs with health savings accounts (HSAs). Individuals with HSAs are likely to view those accounts as resources to pay for medical expenses now rather than to pay for expenses in the future.
Additionally, cost-cutting strategies are hampered by limited or conflicting information. Two-thirds of respondents said they can’t find out how much medical procedures cost when performed by different providers or in different facilities. More than four in ten respondents said they cannot calculate their own out-of-pocket costs when they access medical care.
Despite these cost barriers, individuals enrolled in an employer-sponsored health plan believe they have better insurance than others. More beneficiaries on employer-sponsored health plans say the nation’s insurance industry works better for them than those on Medicare, Medicaid, or who self-purchase.
Date: May 07, 2019