Survey: Half of Americans Will Switch Providers if Subsidies Eliminated

CHICAGO — The upcoming Supreme Court ruling on King v. Burwell may result in more than half of Americans looking for a new healthcare provider that offers more transparent costs and billing, according to a new TransUnion Healthcare survey of insured consumers. If the Supreme Court rules to eliminate the subsidies, more than half (51{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) of Americans will look for new providers, according to the survey.

The importance of healthcare cost transparency is clear. Americans say the opportunity to review cost estimates prior to undergoing treatment is just as important as bedside manner when selecting a healthcare provider, according to the survey. An identical 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of respondents listed upfront cost estimates and bedside manner when asked which experiences would make them more likely to use a clinician.

The same number of respondents (80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) also identified clear billing processes as a major factor, highlighting the growing importance of cost transparency and clarity in determining where patients choose to receive care. In fact, the lack of clarity regularly leads to patient confusion and surprise. Despite improvements in overall billing experience, 61{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of insured consumers say they are always (17{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) or sometimes (44{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) surprised by their out-of-pocket healthcare costs, and 55{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} are always (10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) or sometimes (45{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) confused by the bills they receive.

“This survey suggests that cost and billing experiences significantly influence how patients view their provider and highlights the continued confusion about healthcare bills,” said Gerry McCarthy, president of TransUnion Healthcare. “As consumers become more sophisticated in understanding healthcare costs, providers must be prepared to answer financial questions they were rarely asked 10 or even five years ago.”

The annual survey, fifth in a series of reports that examine patient billing experiences, found patients continue to be cost-conscious and savvier shoppers of health insurance and treatment. The survey found that Americans showed an increased interest in selecting alternative payment plans. The share of those who thought an installment plan would be extremely helpful in paying medical bills rose to 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} the previous year.

Cost transparency when selecting a provider remained particularly important for patients. On a 1-to-7 scale measuring the importance of attributes when choosing healthcare providers (with 1 as most important and 7 as least important), consumers ranked cost transparency as a 4 in both 2014 and 2015.

“Today’s healthcare patients increasingly expect cost transparency and front-end estimates when selecting a provider, and it’s incumbent on the provider to have the technology in place to provide accurate, clear, and fair estimates before treatment,” said McCarthy.

More than two in five respondents (44{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) requested estimates of healthcare costs before a treatment in 2015, up 6{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from 2014. And most respondents (85{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) reported that receiving information about their plan coverage before treatment would be either helpful (31{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) or extremely helpful (54{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}). In turn, this correlates to likelihood of payment, with nearly eight in 10 (79{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) reporting that receiving estimated out-of-pocket costs before treatment would make it more likely for them to pay their medical bills on time.

Patient satisfaction with overall quality continues to be correlated with positive billing and payment experiences. More than eight in 10 patients (83{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) who gave high ratings to their quality of care over the past year also said their billing and payment experiences were usually positive.

Providing cost information and payment options also correlates with positive billing and payment experiences. Two-thirds (66{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) of respondents reported positive billing experiences if they received upfront cost estimates without asking. By comparison, only 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of those who did not receive upfront cost estimates without asking reported positive billing experiences.