Americans have become increasingly concerned about the costs of health care. Prices for medical care can be high, and large medical bills can be a burden to patients, even if they have insurance without high out-of-pocket costs. Numerous studies in recent years have documented the strain high medical bills place on patients, and some have noted patients put off receiving needed care because they are worried about the financial impact. While the Affordable Care Act (ACA) was created to help more Americans afford medical care, having health insurance alone isn’t enough for many patients to pay for care.

Two new studies – one from the U.S. Department of Health and Human Services, the other from the Kaiser Family Foundation – noted the majority of Americans have experienced financial burdens like medical debt because of the cost of care. Patient payments are essential to a hospital’s bottom line and ongoing financial stability, so it’s in the best interest of health systems to make paying medical bills as easy as possible for patients and to provide price transparency to ensure patients are fully aware of the costs of care.

NCHS: One in four families had issues paying medical bills in 2012
The National Health Interview Survey, 2012, from the National Center for Health Statistics (NCHS) found 26.8 percent of families, or groups “of two or more related persons living together in the same housing unit,” have experienced financial difficulties due to medical care. In fact, one in six families had issues paying for their health care and one in 10 families were unable to pay their medical bills at all during the year. In total, one in five families have a type of care payment plan that allows them to pay off their bills over time.

Even those with insurance had difficulties paying for care. Approximately 21 percent of families with everyone having private insurance or public coverage said medical care created a financial burden for them. The percentage of families that have problems providing medical payments increases if some members are uninsured (46 percent) and if some members have public coverage while others have private insurance (35.8 percent).

NCHS researchers examined responses to a national survey from more than 43,000 families, a total of approximately 108,000 Americans.

Kaiser: Those with insurance often fall into medical debt
In a similar study, the Kaiser Family Foundation examined the level of medical debt among those with health insurance. After reviewing interview and survey responses, the foundation found those with chronic conditions were more likely to have high bills from a single health event. Coverage limitations and out-of-network charges were also found to cause patients to have financial difficulties. Twenty percent of nonelderly adults had issues providing medical payments in 2012, 26 percent said they were trying to pay off their bills over time and 11 percent said they were unable to pay their bills at all. In fact, 32 percent said all three.

The Kaiser study also found that those without insurance had more difficulties paying for their medical care (45 percent) than those with private insurance, but one in four people with private insurance still have issues providing medical payments. Thirty-four percent of those with high deductibles experienced problems paying for their care, but so did 24 percent of those with low deductibles, or those with deductibles less than $1,200 for single policies or less than $2,400 for family plans. For those who do pay off their bills, 15 percent of survey respondents say they use credit cards.

Karen Pollitz, a fellow at the Kaiser Family Foundation, told Bloomberg that while the ACA may lessen the burden of care costs for Americans, the issue of financial difficulties and debt due to medical payments continues to be an issue for the nation.

“Unpaid medical bills is the number one reason why families declare personal bankruptcy,” Pollitz said in a telephone interview. “It causes people to lose equity in their homes, to endanger their retirement and their kid’s college education. It will destroy a family financially.”

Hospitals can facilitate patient payments
Health systems can’t afford to sit back and let late patient payments add up. While some hospitals are able to give financial assistance to those who need it, many patients may not qualify for assistance or may still be unable to pay their bills in a timely manner. For hospitals to truly help all patients, they must give patients the information they require to budget correctly and understand their bills.

Traditional medical billing processes are complicated, with itemized bills that can confuse patients about how much they need to pay. Patient friendly billing with cost estimations helps patients make better care decisions according to their income and personal cost responsibilities. Just because patients have insurance doesn’t necessarily mean they don’t require price transparency or easy-to-read bills. Simplifying the billing process and ensuring patients have all the information they require before they receive care can help hospitals increase their patient payments and reduce the number of patients with high medical debt.