Cheat Sheet

Cost Sharing Issue Digest

Our quick take

  • An NORC survey found that 44% of consumers report skipping treatment or medical tests due to the cost, and a third of respondents say they’re forced to choose between health care and life essentials like food, heat, and housing.
  • In addition, JPMorgan Chase Institute reported that consumers immediately increased their total out-of-pocket health care spending by 60% in the week after receiving a tax refund, suggesting that liquidity from the tax refund enabled the increase in health care utilization.
  • Health plans need to carefully consider their cost-sharing design, otherwise they risk undermining cost containment efforts via higher member spend in avoidable, acute care and high variations in seasonal utilization patterns based on variable patient cash flow.

Questions for your next team meeting

  1. How can we calculate the financial impact of care avoidance or non-adherence among our members?
  2. How are we designing initiatives that improve affordability of medical care with new programs targeting social determinants of health?
  3. How can we more effectively partner with providers to minimize the impact of consumer non-payment on hospital margins?

Data snapshot

Trends illustrate why Americans struggle to pay for healthcare today

Consumer Affordability Indicators, 2001-2017


Cost Sharing Issue Digest

Download the full issue digest


Sources:

  1. https://www.jpmorganchase.com/corporate/institute/document/institute-tax-refunds-healthcare-report.pdf
  2. https://www.nber.org/papers/w21632
  3. http://www.norc.org/PDFs/WHI%20Healthcare%20Costs%20Coverage%20and%20Policy/WHI%20Healthcare%20Costs%20Coverage%20and%20Policy%20Issue%20Brief.pdf
  4. https://jamanetwork.com/journals/jama/fullarticle/2661699
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