Forbes: Healthcare illiteracy remains rampant among Americans, new survey shows
Efforts to shield Americans from surprise medical bills—such as the No Surprises Act—may be starting to work. A recent analysis showed two million surprise bills had been avoided in a two-month span.
Now, a new survey of more than 1,000 U.S. workers with employer-sponsored health insurance shows that consumers are doing their part to push back on incorrect medical bills.
According to data released today from employee benefits company Optavise (formerly DirectPath), approximately one-third (35%) of respondents said they had received an incorrect bill in the past three years and 87% of them had pushed back, asking for a new, corrected bill.
Some respondents paid the incorrect bill even though they knew it was wrong. Of these, 70% said it was because the amount of the error wasn’t worth the effort to fix it, a substantial jump from 43% in a 2021 version of the survey. The other 30% said it was because they didn’t know how to fix it, another significant change—down from 52% in 2021, suggesting Americans may be getting savvier about their medical bills.
Despite these potential signs of progress, significant gaps in Americans’ healthcare literacy remain.
Though most survey respondents (71%) reported that they understand key health insurance concepts, 10% admitted they didn’t know what an insurance “premium” is (the set monthly fee you pay for insurance coverage) or what an “out-of-pocket limit” is (the cap on what you have to pay on deductibles, copayments, and coinsurance).
Almost as many (8%) said they don’t know what “in-network” and “out-of-network” mean, terms that refer to whether healthcare providers contract with the health insurer (in-network) or not (out-of-network).
Other common terms also confused some people. Six percent of respondents said they didn’t know what a “deductible” is (the amount you pay for services before health insurance pays for anything). That was triple the percentage who didn’t know it in 2021. The same portion didn’t know what a “copay” is (the fee you pay each time you healthcare services), double last year’s rate.
For many respondents, health insurance concepts are self-taught; 34% had educated themselves through online or other resources. Just 30% had learned about health insurance from their employer’s human resources team, down from 37% in 2021. One-fifth (21%) had learned from a third-party benefits educator or other resource provided by their employer, up from 16% last year.
The survey suggests that people want to learn more about how to manage their health insurance; 39% of respondents said they want to understand how to avoid surprise medical bills and 33% want to know how cost-sharing works.
“It is encouraging that employees want to increase their healthcare literacy rates to improve their financial situations,” said Kim Buckey, vice president of client services at Optavise, in a statement. “More employers, however, need to rise to the occasion. Employees are demanding more financial wellness support, meaning employers need to offer health benefits education.”
Some employers are trying to help. According to the survey, 53% of respondents work for companies that provide online resources to educate employees about health benefits and one-quarter said their employers offered presentations or one-on-one conversations with outside benefit experts.
Still, Buckey said employers need to do more.
“[It] is critical for employees to receive accurate, timely, and consistent information about how to choose and use their health plans so that they—and the company—are not overspending on healthcare services,” she said.
Choosing health benefits
Selecting benefits is a priority for many employees. One-fifth (22%) said they want to know how to choose a health plan.
An increasing percentage of respondents (34% vs. 31% in 2021) had switched health plans in the past year either because their employer had updated and improved plan options (37%), their healthcare needs had changed (29%), or their financial situation had changed (22%).
Among respondents who had switched health plans, equal numbers chose a plan with higher premiums and a lower deductible as chose a plan with a higher deductible and lower premiums. Another 24% chose a high-deductible health plan—which can save money for many enrollees—because their employer offered a health savings account (HSA) or health reimbursement arrangement (HRA).
Most people (76%) who didn’t switch plans said they were satisfied with their current plan, down from 82% in 2021. But a small portion of those who stuck with their health plan did so out of ignorance: 6% said they were too confused by the process or the options to switch, 4% said they didn’t know it was open enrollment season, and 2% just didn’t know how to switch.
We’re not doing it right
The survey showed that a majority of people feel comfortable speaking with healthcare professionals about their care (80%) and have no problem ultimately understanding what their doctor tells them about their treatment (82%).
But still, Americans may not be seeking healthcare optimally, according to the survey results.
The majority (87%) of respondents said they have a regular primary care provider, but just half said they see that person when they need nonemergency care. Instead, 26% said they go to an urgent care clinic, 10% use retail clinics, and 7% use the emergency room, double the 3% who reported doing so last year.
Less than one-third of respondents (31%) said they check on whether a healthcare provider or facility accepts their insurance before getting care, including 48% who check before seeing a new provider and just 10% who check when their health plan changes.
These behaviors are the sort that can lead to unwelcome surprise medical bills and contribute to rising medical debt.
“From inflation to a greater number of Americans facing medical debt, it is critical that consumers have the information they need to make cost-conscious healthcare decisions,” Buckey said.
Read the article here.
(Deb Gordon, Forbes Contributor who writes about how healthcare business and policy impact consumers.)