Subscribers can be overwhelmed by hidden costs

Nov 17, 2014 | Healthcare Industry News

Finding the right policy for your needs takes considerable research and effort. The exchanges constructed under the Affordable Care Act have been improves significantly in usability since their introduction, but U.S. News and World Report has found that many users still experience trouble in understanding out-of-pocket costs.

The source found that many health care consumers are focused on the amount of the premiums on a health plan, and make decisions based on these amounts. However, the plans with the lowest premiums often come with the highest out-of-pocket expenses, turning a plan that might look affordable into one that could result in sudden unforeseen expenses.

Even with the new design of these exchanges, determining the actual costs can be difficult. "The language of cost sharing – deductible, co-payment, coinsurance – can be confusing,"  Susan Pisano, a spokeswoman for America's Health Insurance Plans, which represents the health insurance industry told U.S. News. "But taking the time to calculate these costs is worthwhile."

Plans with high deductibles require subscribers to pay more up-front before their coverage begins. For example, a plan with a $2,000 deductible may have very low premiums and seem affordable, but the subscribers will need to pay the whole $2,000 before they receive any assistance with costs. This can easily create problems of uncompensated care for providers, especially during an emergency event.

Patients being unable to anticipate their care costs can lead to many care facilities experiencing issues with healthcare revenue cycle management as a result of bad debt. If this is the case at your facility, the decision to outsource receivables management can help to improve cash flow and lower the number of dollars written off to bad debt.