Why Out-of-Pocket Costs Prevent Patients from Accessing Healthcare

By Al Posa
President/CEO, HELP Financial

Treating patients is at the center of healthcare, but with the current system of how we supplement costs and make a profit, patients are struggling to make ends meet. This is especially true with out-of-pocket expenses.

These costs are becoming a real strain on families and communities – one of the biggest deterrents to accessing healthcare. With the fear of financial consequences, patients are either hesitant to seek care or avoid it altogether.

Does something so simple like an out-of-pocket cost cause a real danger? In short, yes. Circumstances do matter.

Patients Have Struggled

Consider the woman in January 2020 who sat in the emergency room with chest pain and left after waiting too long. Tashonna Ward, a 25-year-old day care teacher from Milwaukee, wanted to receive faster care but never made it to another center before she suddenly died.

Something as simple as access to healthcare in a timely manner played a part in Ward’s early death. And, with 1 in 4 Americans fearing that insurance costs can go up, imagine the impact it can make on their decisions and health.

There are many reasons why patients are struggling. To fully understand what’s going on, let’s explore some of those reasons and how patients can find hope in a crippling situation.

Patients Have Trouble Paying Health Insurance Costs and Bills

The cost of living is going up, and a significant cost is health insurance. Two-thirds of Americans say they’re concerned about their bills. When families and patients are struggling to make ends meet, they sacrifice things like healthcare to survive. Health concerns that seem minor can get pushed off, but when they grow worse, they cause life-threatening (or costlier) conditions.

Does the economy play a part in this? Perhaps, but not necessarily at face value. The unemployment rate is the lowest it’s been since 1969. At first, we wonder why people still have a problem with bills. But with almost all other costs of living going up, this doesn’t help patients, especially considering that average wages have not been raised in decades. Costs are going up, but salaries aren’t.

When patients receive a healthcare bill, it can make a big impact on their household. They may think twice the next time they need medical attention.

Costs Prevent Necessary Routine Care

Besides living a healthy, balanced lifestyle, the best preventative measure a patient can take to avoid disease and medical emergencies is routinely seeing a doctor. Adults should know that putting their health first and receiving routine care may help them live longer and feel better, but their actions prove otherwise.

Gallup posted the results of their annual healthcare poll, stating “…roughly three in 10 Americans [reported] they held off seeking some kind of medical treatment in the past year due to costs.” Decreased routine care increases the chances of significant medical costs in the future for patients as their conditions worsen.

When patients feel they can’t afford to pay their health bills, they choose to then skip out on their routine care, prescriptions, and more.

Debt is at an All-Time High

Not only are patients paying more while their wages remain stagnant, but they owe more debt as well.

Regarding health costs, consider the inflated costs in America vs. the costs in Australia. Hospital stays in the United States cost an average of $5,220 per day. In Australia, it’s $765 a day. With costs like these, out-of-pocket bills are bound to be much higher for patients. When they can’t pay the bills, they turn to loans to support their lives.

Debt has also risen in other areas of life. Americans are buying bigger homes, and in many cases underestimate the impact of a higher mortgage. The Atlantic states “In 1973, when the Census Bureau started tracking home sizes, the median size of a newly built house was just over 1,500 square feet; that figure reached nearly 2,500 square feet in 2015.” With higher property taxes and home costs, this has implications for families.

Student loans and credit card debt have also played a role. With several forms of common debt rising in the United States, healthcare costs have created a tipping point for many households. And when costs seem inflated with healthcare, patients have a hard time justifying paying sacrificial costs.

What Can Be Done for Better Access to Healthcare?

Anybody who has paid attention to the healthcare industry and its politics knows that a lot of factors need to change to benefit patients and make their lives easier. But as healthcare professionals, we have the power to make life-changing steps for those we treat.

The key to making a difference is by shifting our attention to making payments easier for our patients. When hospitals and health executives choose to partner with a company that provides patient-focused payment plans, such as HELP Financial, they can increase their collection performance and patient satisfaction.

Once patients can again afford their healthcare, they’ll seek more care. This makes them healthier, happier, and increases visits and services for providers.

Does creating payment plans really make that much of a difference? Absolutely. The biggest problem with bills coming in, or out-of-pocket expenses, is the timeframe in which patients must pay and the fear that comes with staring at a large amount. It’s easy to feel overwhelmed and hopeless. When paying healthcare bills is more possible, patients live a life with less stress, which makes for a better world and lowers the chance of future chronic illnesses.

When we create a payment process that is made for our patients and their needs, we can build a healthier country. Big problems require intentionality, and it can’t be done alone. Through fruitful partnerships, problems like access to healthcare can be overcome.

Remove Financial Obstacles for Patients

While out-of-pocket expenses create financial obstacles and prevent access to patient healthcare, there’s a solution to give patients hope and create a healthcare environment made with them in mind. A patient-center payment solution makes this possible.

Creating a better health environment for patients builds the opportunity for families to have access to healthcare they truly need. Healthcare is a noble business, focused on taking care of each other.

HELP Financial has options to fit your facility's needs. We provide a superior system to manage and collect the patient portion of health care bills. Our programs are designed for the patient's success. When the patient succeeds, we all succeed.

Contact us today to learn how we can HELP.