The Commonwealth Fund has ranked the U.S. healthcare system last out of 11 developed countries, despite spending the highest percentage of its gross domestic product on health care for its citizens. One reason for this? Affordability concerns among U.S. patients. As a result, many patients find it difficult to access care in a timely manner.

The Commonwealth Fund analyzed 71 performance measures across five “domains” to determine its ratings. The domains include access to care, care processes, administrative efficiency, equity, and healthcare outcomes. The other countries ranked in the analysis include: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.

Affordability Concerns are Prevalent in the U.S.

In its coverage of the just-released report, The Washington Post interviewed Eric Schneider, the lead author of the report.

“We’ve set up a system where we spend quite a bit of money on health care, but we have significant financial barriers, which tend to dissuade people from getting care,” said Eric Schneider, senior vice president for policy and research at the Commonwealth Fund, which conducts independent research on health-care issues.

Schneider’s pronouncement aligns with findings from Patientco’s 2021 State of the Patient Financial Experience survey. The findings revealed that more patients cited affordability concerns than COVID-19 as the reason for skipped care. Nearly 1 in 3 patients, 32%, has avoided recommended treatment because they worried about what they would owe. Meanwhile, about 15% of patients skipped care because they lacked health insurance, which translates to higher out-of-pocket costs for patients. However, just 27% of patients skipped care over fear of being exposed to COVID-19.

For patients who can afford it, the U.S. is internationally known for high-quality care. In fact, the Commonwealth Fund ranked the U.S. second on care process. which measures things like engagement with patients. However, the U.S. falls behind on access to care, administrative efficiency, equity and healthcare outcomes.

What’s most alarming? The report sheds light on the U.S. rate of preventable mortality. It’s more than double that of Switzerland, the highest performing country in that category. The authors concluded that: “Achieving better health outcomes will require policy changes within and beyond health care.”

The Time for Change is Now 

But, health systems don’t have to wait for U.S. policy to evolve. Instead, they can begin to initiate positive change by overhauling their business office operations. Financial barriers, such as affordability concerns prevent U.S. patients (even those that are commercially-insured) from seeking the care they need. We can empower the business office to alleviate some of these frustrations.

Here’s how: 

  • Make sure patients can access affordable payment options before they receive care. Sticker shock from price estimates cause nearly 1 in 4 patients to cancel visits, according to Patientco’s 2021 State of the Patient Financial Experience Report. Upfront, affordable payment options on estimates help ensure patients keep their scheduled appointment. This reduces the risk of no-shows and the likelihood that patients will shop around for another provider with a lower cost.
  • Use bill balance amount to personalize engagement with patients. For medical bills that exceed $500, 45% of patients would need financial assistance. For bills that exceed $1,000, the percentage is even higher, as 66% of patients would need assistance. Looking at a patient’s bill balance powers a more personalized interaction and ensures each patient has a way to engage and manage their healthcare expenses.
  • Offer a variety of flexible payment options to address affordability concerns. Even patients in high-income households have affordability concerns. According to Patientco’s survey report, 85% of patients with household incomes greater than $175,000 are less likely to defer care with affordable payment options. Be sure to present a variety of flexible payment options, such as financing programs and monthly payment plans, with online enrollment. This gives your patients immediate access to affordable payment options that work for them. 

Elevating Healthcare, Starting with the Business Office

Barriers to care, which are oftentimes financial barriers, prevent patients and entire communities across the U.S. from achieving better health outcomes. Patients should trust their providers to do no harm, both physically and financially. 

With the right technology and processes in place, the business office team can be a powerful advocate for both patients and the health system. Health systems that empower their business office team to remove the barriers that prevent patients from seeking care are making a profound investment in their patients’ trust and ultimately, the health of the communities they serve.

Meet the Author: John W. Mitchell’s job titles have ranged from sailor in the U.S. Navy (broadcast-journalist aboard an aircraft carrier) to COO and CEO for several hospitals. In 2009, HealthLeaders Media named John and his senior executive team the Top Leadership Team in Healthcare for turning around a 90-bed, regional Washington hospital. In 2012, he started his own business, SnowPack Public Relations. John is widely published as a freelance reporter and writer in the hospital, healthcare, and medical sectors. More recently, his projects include writing content on behalf of Patientco. John is also the author of the novel Medical Necessity (four stars on Amazon), and a commercially successful landscape and wildlife photographer.