Preventing Medical Debt: Recommendations for Insurers
This report shows how the shifting health insurance landscape has helped shape the medical debt crisis, identifying specific actions insurers should take now to boost Americans’ confidence in their coverage and motivate them to pursue timely care that reduces the need for costlier services.
91% of Americans
do not understand the meaning of premium, deductible, out-of-pocket maximum, and co-insurance.
62% of U.S. adults younger than 65
who report problems paying a medical bill say that the person who incurred the bill was insured at the time.
24% of underinsured adults
say they don’t visit a doctor when they have a medical issue.
Key Recommendations
With input from members of our Stakeholder Advisory Council, the Financial Health Network developed recommended actions and strategies for insurance providers to help prevent medical debt. Although each recommendation is effective as a stand-alone, insurers can achieve the greatest impact by implementing them all.
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- Aid members in plan selection, and ensure members understand key health insurance terms.
- Proactively inform members of out-of-pocket expectations, and help them navigate lower-cost options through price transparency resources.
- Incentivize primary and preventive care services by reducing or eliminating associated out-of-pocket expenses.
- Improve claims adjustment and prior authorization processes.
Systems-Level Overview
Explore insights into the prevalence of medical debt and its effect on consumers, how medical debt functions as a social determinant of health and driver of health inequities, and opportunities for key players to prevent it.
Recommendations for Hospitals and Health Systems
Read about actionable strategies healthcare providers should take now to improve financial assistance and repayment programs, support informed patient decision-making, and proactively identify patients at risk for medical debt to target financial assistance.
Recommendations for Employers
Find out about proactive steps employers should take now to assess employee health insurance affordability, educate their workforce on insurance basics and out-of-pocket costs, help workers manage healthcare expenses, and offer plans based on employees’ needs and circumstances.
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Written by
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Michelle ProserSenior Director, Healthcare Solutions -
Manager, Healthcare Solutions
Preventing Medical Debt: Recommendations for Insurers
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