Hospitals are preparing for an increase in unpaid bills from patients covered by the health exchange's bronze plans, which have an average individual deductible 42 percent higher than that of an individually purchased plan in 2013, according to a Wall Street Journal report.
The WSJ cites HealthPocket's analysis of insurance offerings in 34 of the 36 states that are using the federally run marketplace. The average annual deductible for a bronze plan on the exchange is $5,081. That figure was $3,589 for an average individually purchased plan in 2013 before the federal law took effect.
The WSJ uses an example of the average cost of having a baby through a normal delivery. One insurer estimated that would cost about $6,150, meaning it would be an almost entirely out-of-pocket expense for a person holding a bronze plan with the average $5,081 deductible.
The number of people who have purchased bronze policies is unknown, as the exchanges are not releasing those detailed figures. But hospitals are still bracing themselves for more the implications of patients having more "skin in the game," such as patients not paying their bills or reducing their use of medical services, especially emergency care.
In October, Moody's Investors Service said several exchange-related risks would put pressure on nonprofit hospitals' revenue in 2014, including reduced patient volumes and an increase in unpaid bills associated with the higher deductibles.
Still, many Americans who were uninsured are benefiting from the exchanges despite the average deductible price, particularly for high-cost care like cancer treatments, according to the WSJ. Hospitals will also be treating more people with coverage than before the law, so they will be paid by insurers for some services that had previously ended up on their spreadsheets as bad debt.
High-deductible health plans will place a greater collection burden on providers, as hospitals' average recovery rate for collections is a little more than 11 percent. Nonhospital providers average about 17 percent. This issue will compound the reduced reimbursement rates physicians, particularly, face under commercial plans on the exchange. A WSJ article last month said some commercial rates for plans on the exchange resemble Medicaid rates, and many physicians have declined these contracts so far.
More Articles on High-Deducible Plans and Hospitals:
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