KHN: Hospital bad debt climbs as coverage costs are shifted onto workers

Posted on: August 13, 2013

Aug. 13, 2013 — The rise of high-deductible health plans has left many patients unable to pay their full medical bills, causing bad debt levels to climb at some hospitals, Kaiser Health News‘ “Capsules” blog reports.

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According to the Kaiser Family Foundation, 19% of employer-covered workers last year were enrolled in high-deductible plans, which are insurance policies with family deductibles as high as $5,000 that are often paired with health savings accounts. That’s more than double the rate of workers in high-deductible plans in 2009.

Supporters of the plans say they force workers to pay more attention to costs, encouraging them to avoid needless care and shop for the best deals. However, hospitals say patients enrolled in such plans struggle to pay for their care.

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“We have definitely been hearing from members that they are seeing an increase in bad debt and even in charity care for people with high-deductible health plans,” says Caroline Steinberg, the American Hospital Association‘s vice president for trends analysis. She adds, “A lot of these folks tend to not understand the structure of their benefits until they get to the hospital, and they’re not covered as thoroughly as they thought.”

Tenet Healthcare CFO Daniel Cancelmi last week told reporters that the “number of accounts that we’re seeing that relate to these high-deductible plans has been building, and it has been putting pressure on our bad debt levels” (Hancock, “Capsules,” Kaiser Health News, 8/12).