A recent study suggests that some older persons resist seeking medical help even when they think they may need it because of concerns about how much emergency care could cost them. According to research published in the American Journal of Managed Care, 22% of older adults who may need emergency room care stayed home because of concerns about potential costs. People in their 50s and early 60s, women who lack health insurance, people with household incomes under $30,000, and people who say their mental health is fair or poor are most likely to say They avoided getting emergency care because of cost concerns.
The study, based on a survey conducted in June 2020, asked older adults to think back over the past two years, including the months before the COVID-19 pandemic. Even among those who had not had a medical emergency at this time, there was concern about what the emergency visit might cost. Four out of five older adults said they were concerned about the cost of emergency care (35% were somewhat concerned and 45% were very concerned, and 18% were not sure they could afford a visit.
The study’s data comes from the National Poll on Healthy Aging, which is based at the University of Michigan Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s Academic Medical Center. The findings are based on a previously published poll report and responses from a nationally representative sample of 2,074 people aged 50 to 80. The findings corroborate the experience of lead author Rachel Solnick, MD, MSc, who trained at IHPI’s National. Clinician Scholars Program before joining the faculty at the Icahn School of Medicine at Mount Sinai Health System in New York.
“As an emergency physician, I see patients come into the emergency room, their care postponed. They often get sick because they could have gotten care sooner,” she said. “This scenario is what I find most alarming in the findings of this survey. Some groups who are medically vulnerable or facing worse outcomes from COVID-19 experience increased cost-related avoidance of ER visits than their counterparts. These findings highlight the importance of reducing the number of uninsured individuals and the need for insurers to clearly communicate coverage for emergency services.”
Keith Kocher, MD, senior author of the study and an associate professor of emergency medicine at UM, notes that the federal No Surprises Act was put into effect after the study was done. The act seeks to reduce “surprise billing” for emergency care when a privately insured person receives it from hospitals or providers outside their health insurance plan’s network. At the time of the study, Medicare and Medicaid already prohibited emergency care providers from doing this kind of “balance billing.” Even then, a person with private insurance may have to pay hundreds of dollars in co-pays or deductibles for emergency travel. Note to the author. This is especially true for people with high-deductible health plans, which are increasing in enrollment.
Even though the percentage of older adults who have no health insurance is low (4% of the study sample), they were 35% more likely to say they were not sure they could afford emergency care. Solnick noted that the economic impact of the pandemic and the decision by more than a dozen states, including Texas and Florida, not to expand Medicaid to all low-income adults means millions of people may be left out-of-pocket for emergency visits. may have to be paid.