Many hospitals offer financial aid to patients, but need to improve outreach

Many patients who seek financial help are offered it by hospitals — an important accomplishment they should promote to policymakers and patients who need help, said a researcher.

Additionally, those organizations need to improve outreach and options, said the researcher.

Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics, discussed recent research she co-authored that surveyed people on medical bills they received and with which they had issues around accuracy or affordability.

Her research found that among the 61% who reached out to their provider:

• 49% who could not afford their bill received financial aid, bill cancellation, and/or price reductions
• 27% who could not afford their bill received a payment plan
• 74% who thought their bill was too high because of a mistake had their bill corrected
• 62% seeking to negotiate the price had the price reduced

Overall, 76% of the respondents who could not afford their bill and reached out received some form of financial relief, she said during the HFMA Annual Conference.

Through personality tests of respondents, the research found those who reached out were more likely extroverted and disagreeable, and they also found callers were higher educated and more financially literate.

She urged providers to make more efforts to inform patients broadly about their assistance options, so available help is not limited to just the “the person who is willing to be obnoxious and super pushy.”

Unknown assistance

Additional research Duffy co-authored looked at hospitals with available information for underinsured patients seeking non-emergent care and the findings included:

• 87% offered financial assistance
• 97% offered payment plans

The findings surprised Duffy.

“When I looked at the ‘allowed amount’ line, I assumed that’s what the hospital gets paid,” she said. “But no, because a lot of times—what I learned through this study—at many hospitals you are giving discounts off of that allowed amount,” she said. “Your policymakers are also only seeing those allowed amounts.”

The difference between publicly available allowed amounts for providers and what ultimately is obtained from patients is a blind spot for policymakers and most researchers, she said.

“Y’all are giving discounts off of those rates all of the time and you’re not necessarily getting credit for that publicly,” Duffy said.

Room for improvement

Government mandated price transparency information has only limited benefit for patients with large out-of-pocket costs because they will need payment plans to afford those, she said

“Ultimately, that top line sticker price is not what they would pay because often it’s about how what they owe, given today, gets broken up in their monthly budget — what can they pay off over time,” Duffy said.

Such patients can benefit from payment plans from providers.

Although her research found the overwhelming majority of hospitals offer some sort of payment plan, “often the details of those plans are not available online.”

Instead, most hospitals require patients to call to discuss details of the payment plan. One problem with that was that 18% of hospitals were unreachable by the secret shoppers assisting with her study.

Among the 82% of hospitals that were reachable, obtaining the correct information on the calls frequently required transferring between multiple departments, including the billing department, the financial assistance department or the admissions office.  “I get how you end up with a system where patients are getting transferred to three different offices but I also get that that is a lot of friction” for patients, she said.