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Millions putting off seeking care due to high out-of-pocket costs

Healthcare Dive
Gallup: Insured patients avoid care due to cost
By Anne Zieger | December 3, 2014
Dive Brief:

According to a new Gallup poll, millions of Americans who have health insurance are forgoing care because
they don't believe they can afford their out­of­pocket expenses. One in three Americans told Gallup that they
had put off seeking care because of the cost, among the highest response rate since Gallup began asking
this question in the year 2000.

Patients with incomes under $30,000 per year were least likely to put off care, with 35% saying they had done
so this year, down from 43% last year. Meanwhile, middle­class and higher income families with incomes
between $30,000 and $75,000 per year were more likely to put off care this year than last year, with 38%
postponing care as opposed to 33% in 2013. And the percentage of those putting off care above $75,000 a
year went up from 17% last year to 28% this year.
Among those that have put off treatment, 22% said it was for a serious or somewhat serious medical
condition.

Dive Insight:
With patients facing higher deductibles for the health plans than ever before, it's
hardly surprising that growing numbers are putting off care. While high­deductible
plans assume that patients can self fund the deductible, making them smarter
shoppers, the Gallup data suggests that even among higher income brackets, many
patients don't feel they can afford to do so.


This data should alarm healthcare industry leaders and policymakers. After all,
current efforts around ACOs and population health management assume that
providers can intervene to promote wellness and manage chronic conditions before
they become too costly. If patients fail to get the care they need because they can't
afford to pay for it, it completely defeats the purpose of such population management
efforts.


Ultimately, those who back high deductibles and those who are trying to lower health
costs by promoting wellness and intervening early in care of the chronically ill are
headed for a collision. Arguably, these competing incentives—a desire to avoid
excessively costly care in patients and the need to control population health costs
—aren't compatible.

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