Inaccurate Procedure Estimates Haunt Healthcare Consumers.

Even when they have obtained a cost estimate in advance for a surgery, American patients still have trouble affording medical care. Oftentimes,…

Even when they have obtained a cost estimate in advance for a surgery, American patients still have trouble affording medical care. This estimate is frequently either wildly off or just plain wrong. Additionally, the estimates are typically on the low side of accuracy.

This continues to be a barrier to customers’ trust in the healthcare system, according to a PYMNTS.com survey of roughly 2,500 Americans who use health care services. The survey was done by PYMNTS.com, a source of statistics, news, and insights on innovation in payments and payment-related topics, to determine how many respondents fell into the group of surprisingly high and inaccurate estimates and what happened to them as a result.

The results were essentially divided into three groups: patients who received unexpectedly high estimates and cancelled an appointment; patients who received a high estimate but underwent the recommended medical treatment; and patients who underwent the procedure but then received an unexpectedly high bill. Here are the results of the survey:

• Following a high cost estimate, 75% of Millennials canceled a medical appointment.
• When given a high cost estimate, 6 in 10 people who live paycheck to paycheck and struggle to pay their bills canceled a medical appointment.
• A high cost estimate was the primary justification given by nearly half of patients who canceled a medical appointment other than because “their condition has improved.”

But only 13% of seniors and baby boomers canceled after getting an unexpectedly high estimate. Given that the majority of people probably benefit from Medicare and have reasonably priced gap insurance, the financial blow would be much less severe for this group.

The survey revealed that many consumers continue to under budget for their health care –probably because most have little idea about the cost of various procedures and appointments. For instance, over 20% of respondents claimed they “had financial strain related to health care expenditures because they spent more than they could afford in the preceding 12 months,” and 25% of those who felt their advance warning cost estimations were accurate claimed they still overspent. It should come as no surprise that 43% of people who obtained erroneous cost estimates claimed they spent more than they could afford.

Stressful as it may be, living paycheck to paycheck can cause more financial concern than other groups.

According to the poll, 27% of patients who said they struggled to pay their bills and were living paycheck to paycheck did not have enough money to cover their most recent appointment. Comparatively, over the same time period, 11% of patients who did not live paycheck to paycheck experienced financial hardship as a result of medical expenses, and only 25% of those people canceled a medical appointment as a result of receiving a high cost estimate.

However, physicians who provide erroneous cost estimates before a surgery run the risk of facing backlash. The survey indicated that 60 percent of patients who paid out-of-pocket health care costs and received either an erroneous cost estimate or an unexpected bill are “very” or “extremely” interested in switching health care providers for a better payments experience.

Source: https://www.benefitspro.com/2022/08/02/health-care-consumers-plagued-by-inaccurate-procedure-estimates/