Insurance Complexity and Restrictions Create Concerns for Patients and Doctors Adults, 2013 Insurance did not cover as expected/spent a lot of time on.

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Learning by Comparing: Experiences of Adults in Eleven Countries Findings from the Commonwealth Fund 2013 International Health Policy Survey and Health.

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THE COMMONWEALTH FUND The Commonwealth Fund 2013 International Health Policy Survey in Eleven Countries Robin Osborn and Cathy Schoen The Commonwealth.

Adults with Medical Bill Problems Had Lingering Financial Problems

Subsidized private insurance

Adults Insured All Year with Medicaid Coverage Reported Lower Rates of Medical Bill Problems Than Adults with Private Coverage and Those Uninsured During.

There Has Been a Modest Reduction in Reports of Medical Bill Problems by Women Percent of women ages 19–64 who reported any of following bill or medical.

Uninsured Adults and Those with Coverage Gaps Reported Medical Bill Problems at Higher Rates Than Did Those Continuously Insured, 2016 Percent of adults.

Uninsured Adults and Those with Coverage Gaps Reported Cost-Related Access Problems at Higher Rates Than Did Those Continuously Insured Percent of adults.

Doctors Use Electronic Patient Medical Records*

250% FPL or more Total Less than 250% FPL

Across all coverage sources, some adults plan to drop insurance after mandate repeal The tax bill passed by Congress in December 2017 made a change to.

Fewer Women Say They Are Not Getting Needed Care Because of Costs

Women in the U.S. Report Highest Rates of Not Getting Needed Care Because of Cost Percent of women ages 19–64 who experienced any access problem because.

Adults in California and New York Reported Lower Rates of Cost-Related Access Problems Than Those in Florida and Texas Percent of adults ages 19–64 U.S.

Three of Five Adults with Medicaid or Marketplace Coverage Who Needed to See a Specialist Waited Two Weeks or Less How long did you have to wait to get.

Percent of adults ages 19– In the past 12 months:

The Commonwealth Fund 1998 International Health Policy Survey

More Than One-Third of Young Adults Experienced a Medical Bill Problem or Were Paying Off Medical Debt Percent of adults ages 19–29 who experienced the.

Financial Incentives and Targeted Support

The Number of Adults Without Insurance, Forgoing Health Care Because of Cost, and Paying Large Shares of Their Income on Health Care Has Increased, 2001–2010.

Seventy-Five Percent of Uninsured Adults Ages 50–64 Reported a Cost-Related Problem Getting Needed Care Percent of adults ages 50–64 Rtoopf5 rtcsf10 newdebt.

Doctors Use Electronic Patient Medical Records*

Doctors Use Electronic Patient Medical Records*

Women in Switzerland and the U.S. Report Very High Out-of-Pocket Costs

One-Quarter of Women in the U. S

High-Need Adults Are More Likely to Be Socially Isolated

Inadequate Coverage Is Associated with More Problems Paying Medical Bills Percent of adults ages 19–64 who had medical bill or debt problems in past year*

Only 28% of U.S. Primary Care Physicians Have Electronic Medical Records; Only 19% Advanced IT Capacity, 2006 Percent reporting 7 or more out of 14 functions*

An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health Care Because of Cost,

Women Are More Likely to Have Access Problems and Medical Bill Problems in Past Year, 2007 Percent of adults ages 19–64 reporting the following problems.

High Chronic Disease Burden Among U.S. Women

Percent of adults ages 19– In the past 12 months:

More Than One-Third of Women in the U. S. Skip Care Because of Cost vs

2008 Survey Profile of Sicker Adults with Any Chronic Condition

Medical Bill Problems and Accrued Medical Debt, 2005–2007

More Than Three-Quarters of Adults with Medicaid or Marketplace Coverage Who Tried to Find a New Primary Care Doctor Found It Very or Somewhat Easy Over.

Adequately insured 48% Uninsured anytime 15% Uninsured anytime 36%

Reasons for Skipping Cancer Screening Tests

Inadequate Coverage Is Associated with More Cost-Related Problems Getting Needed Care Percent of adults ages 19–64 who had any of four access problems.

Any Gaps in Hospital or Surgery Discharge in Past Two Years

Doctors Use Electronic Patient Medical Records*

Payment System Options

Adults with Health Problems Who Have an Excellent Patient Experience Report Greater Support to Help Manage Their Health Condition Percent of adults 18–64.

Two-Thirds of Those Who Found a Primary Care Doctor Got an Appointment Within Two Weeks How long did you have to wait to get your first appointment to.

Subsidized private insurance

Cost-Related Access Problems and Medical Bill Problems Are Significantly Higher Among Latinos Uninsured During the Year Percent Latino adults ages

Doctors Use Electronic Patient Medical Records*

Doctors Use Electronic Patient Medical Records*

Medical Bill Problems or Medical Debt

Hospital or Surgery Discharge Gap in Past Two Years, by Medical Home

Percent of adults ages 19–

Doctors Use Electronic Patient Medical Records*

Three of Five Adults with New Coverage Said They Had Used Their Plan; of Those, Three of Five Said They Would Not Have Been Able to Access or Afford.

Percent of adults (ages 19–64)

Problems with Medical Bills or Accrued Medical Debt Increased, 2005–2007 Percent of adults ages 19–64 with medical bill problems or accrued medical debt.

Sixty Percent of Those Who Found a Primary Care Doctor Got an Appointment Within Two Weeks How long did you have to wait to get your first appointment.

Base: Adults with any chronic condition

Among those with Internet access, percent reporting ability to:

Access Problems Because of Costs, By Income, 2007

Adults with Health Problems Who Have an Excellent Patient Experience Are Most Likely to Be Well-Informed About Their Prescription Medications Percent of.

Doctors Use Electronic Patient Medical Records*

The Share of Women Spending 10 Percent or More of Their Income on Health Care Climbed over the Past Decade, Especially for Women with Low Incomes Percent.

Patient Engagement in Care Management for Chronic Condition, by Medical Home Percent reporting positive patient engagement in managing chronic condition*

More Than Three of Five Adults Who Selected a Private Plan or Enrolled in Medicaid Were Uninsured Prior to Gaining Coverage What type of health insurance.

Percent of adults (ages 19–64)

Under the Affordable Care Act, Young Adults Will Benefit from Newly Subsidized Sources of Health Insurance Percent of young adults ages 19–29 Total

Doctors Use Electronic Patient Medical Records*

A Majority of Adults Potentially Eligible for Coverage Who Have Not Yet Enrolled Say They Are Likely to Shop for Coverage by March 31, 2014 The enrollment.

Percent of currently employed adults ages 19–64

The Number of Adults Reporting Not Getting Needed Care Because of Cost Declined in 2014 for the First Time Since 2003 Percent of adults ages 19–

Presentation transcript:

Insurance Complexity and Restrictions Create Concerns for Patients and Doctors Adults, 2013 Insurance did not cover as expected/spent a lot of time on paperwork in past year* Primary care physicians, 2012 Insurance coverage restrictions pose major time concern** Percent * Adults spent a lot of time on paperwork or disputes over medical bills and/or insurance denied payment or did not pay as much as expected in the past year. ** Amount of time doctor or staff spend getting patients needed medications/treatments because of coverage restrictions is a major problem. Source: 2012 and 2013 Commonwealth Fund International Health Policy Surveys.