The drive to create better-informed health care consumers may have stalled, a new study suggests. The survey from Waystar, a revenue management software company, shows that nearly 90 percent of consumers are not price-shopping before routine health care visits. After years of effort from insurers and providers alike to make health care a more consumer-driven industry, the results suggest that most patients are either not willing or not able to shop for health care the way they shop for other services. In addition, the study outlines how younger patients are struggling with hospital bills.

The Waystar survey focused on consumer experiences with hospital business officers, polling 1,000 Americans on their experiences with hospital visits in the past year. It found that 12 percent of survey respondents said they price shopped before their visit, and 88 percent did not. In addition, 79 percent of respondents had not discussed their bill with the hospital or did not plan to. Twenty-one percent said they had talked to the hospital business office, or planned to, about their final bill. A higher percentage, 35 percent, had compared their bill to their explanation of benefits from their insurance company.

Confusion, complexity, lack of transparency a burden for consumers

The survey found that not understanding medical bills continues to be an issue for patients: 56 percent of patients who reported a negative experience billing experience with their last hospital visit listed some variation of confusion or lack of information as the biggest problem.

The largest percentage (26 percent) said lack of transparency in pricing was the biggest problem; 23 percent said it was insurance coverage; 14 percent listed complex medical bills; 11 percent said the biggest problem was lack of support in the payment process; 10 percent listed Other; 9 percent said lack of communication channels, and 7 percent of dissatisfied customers said the biggest problem was confusing payment options.

Consumers also seemed not to feel comfortable contacting hospitals in advance with questions or issues: only 28 percent of respondents talked to the hospital in advance or received an out-of-pocket expense estimate, the report said.

Younger consumers struggling more

Another finding of the Waystar report is that younger consumers have more trouble paying their hospital bills. The survey notes that wealth has been stagnating for younger Americans, causing them to feel more burdened by rising health care costs. “While all respondents are struggling with health care costs, the younger generation (18-39) is the hardest hit,” the report said. “Many choose to delay care to keep medical bills at bay, and others reveal medical debt is impacting their savings and setting them back financially.”

The survey found that for respondents aged 18 to 39, 35 percent owed $100 or more in out-of-pocket costs from their last hospital visit. Younger respondents were also less likely to know what they owed—a third said they did not know their balance. And 76 percent of younger patients said they had to forgo a procedure or treatment that would have helped their quality of life due to cost.

Younger patients also prefer online options

Waystar’s report recommended that hospitals do more to customize the billing process, in order to meet the individual needs of consumers. Not surprisingly, younger patients prefer online payment options, while older patients still preferred to get their bills and make their payments by mail.

Top changes that the survey suggests for hospital business offices:

Simpler bills that show a total balance (preferred by 45 percent of respondents)
More payment plan options (42 percent)
Access to an online portal (41 percent)
A dedicated team to work with in the business office (36 percent)

“In an era of high-deductible health plans and increasing demands for price transparency, we’re glad to see a surge of legislation around price disclosure,” said Waystar CEO Matt Hawkins. “But our study found that, even with improved price transparency, a one-size-fits-all approach to patient billing doesn’t make sense. There’s still a lot of information for patients to decipher and providers need to prioritize clear, tailored communication with patients. Only then will we truly build a better patient financial experience and revenue cycle.”

Read more:

Instant Insights /

Consumers still confused by health care shopping, billing practices

More From HR Executive

Related Stories

Recommended For You