High deductibles cause confusion, hardship for docs and patients

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Nearly a third of U.S. adults said they put off getting medical care because of costs in 2012, according to a new Gallup poll. This year's 32 percent figure is the highest since Gallup started tracking the phenomenon in 2001, when 19 percent of those polled said they skimped on care due to costs.

As in years past, more health consumers delayed getting care for a serious condition (13 percent) than a nonserious one (19 percent), CBS News reported. In addition, Gallup reported that 55 percent of uninsured adults had to put off care, while 30 percent with private health insurance and 21 percent of survey responders with Medicare or Medicaid did so.

It's unknown how many of the 1,000 individuals polled by Gallup put off care that was preventive because they didn't know it was fully covered by their insurance, an element of health reform still causing a great deal of confusion for physicians and patients. Purchasers of high-deductible health plans, in particular, seem to be unaware of the benefit, as a recent study published in Health Affairs revealed that almost 20 percent of 456 California-based healthcare consumers didn't know their HDHPs covered preventive office visits, FierceHealthPayer reported.

Likewise, many physicians are still struggling to determine what patients with HDHPs do have to pay for and to collect on those balances effectively, noted a recent article from Medscape Today. "It's easy for the physician to know what the copay is, but the deductibles are trickier, particularly at the beginning of every year," said Andriolo-Bull, when the deductibles start anew. "The physician typically doesn't have access to information on where the patient is on his/her deductible."

According to Andriolo-Bull, pre-visit eligibility checking and real-time claims adjudication can be powerful tools in helping doctors fulfill their responsibility to disclose costs to patients and ensure the practice gets paid.

To learn more:
- see the statement from Gallup
- read the story from CBS News
- read the article from Medscape Today

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