Uncompensated Care at Hospitals Keep Rising Thanks to Higher Healthcare Deductibles

The amount of the average healthcare insurance deductible has tripled during the past decade, and chief financial officers of hospitals consider every dollar of a high-deductible health plan to be a dollar of bad debt that will not be repaid, according to a published report.

For workers with single coverage, the average deductible was $1,655 in 2019, a figure that has grown threefold during the past 10 years.

The increase in deductibles and rising amounts of bad debt have continued to escalate the amount of uncompensated care at hospitals nationwide, although the rate of the increase is slowing compared to a few years ago.

“A lot has to do with high-deductible health plans and co-insurance,” said Kevin Holloran, senior director with Fitch Ratings, in the report. “Hospital CFOs I talk with say a $5,000 health plan is $5,000 in bad debt—most don’t have the capacity to pay that back.”

Hospitals, on average, had $12.8 million in uncompensated care in 2018, up from $11.2 million in 2015, according to the report. The amount increased by 8% from 2015 to 2016, but has slowed to a 3% annual increase since then. Large hospitals — defined as those with more than 250 beds — had an increase in uncompensated care to $39.7 million in 2018 from $33.2 million in 2015. For smaller hospitals — defined as those with less than 25 beds — the amount of uncompensated card increased to $2.3 million in 2018, from $1.8 million in 2015.

Those figures are expected to increase, especially as more individuals opt for high-deductible health plans.

“This isn’t a business anymore where you can implement a cost-saving or revenue-growth strategy and turn away from it — it requires constant work and vigilance,” Holloran said. “These financial pressures are not going away anytime soon.”

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