Depending on where you live, healthcare is almost synonymous with high expenses. In the U.S. at least, we now expect that extensive medical treatment – whether that’s chemotherapy, ongoing dialysis visits or surgery to repair a broken femur – may involve significant medical bills. Hospital stays, outpatient visits, tests and medications can all add up, even when patients have health insurance. New types of treatment and protocols can come with sky-high costs. Prolonged illness can involve nonmedical expenses like travel, hotel bills or childcare and the cost of a career put on hold for months or even years. The 15.5 million cancer survivors in the U.S. must pay not only initial diagnostic and treatment costs but the long-term costs of survivorship.
In practical terms, this means many patients are forced to deal with crippling debt, filing bankruptcy and losing their homes right as they’re trying to recover from an illness. The Centers for Medicare & Medicaid Services (CMS) reports that of $3.5 trillion in U.S. healthcare spending in 2017, Americans paid $365.5 billion out of pocket. In that light, it’s not surprising that 66.5 percent of all bankruptcies are caused by medical bills.
But what may seem to be separate burdens – suffering through illness and struggling to pay off medical debt – can actually intertwine into what experts call financial toxicity. A distress common to Americans with serious or chronic diseases, financial toxicity can diminish treatment outcomes and impact physical and mental health.
The Impact of Financial Stress
Patients who’ve worried about finances during a debilitating illness have likely experienced the physical impact of stress. Chest pain, digestive disorders, depression, substance misuse, anxiety and insomnia are all common effects. Over time, chronic stress can fuel problems with high blood pressure, obesity, diabetes and heart disease. In an expensive healthcare system, that means the very care people seek to become healthy can saddle them with costs that fuel stress-related ailments. A family struggling to afford one sick child’s care may also skip preventive care or required services for other family members.
Consider these findings:
- A white paper by Family Reach and Xcenda found that cancer patients were 2.65 times more likely to file for bankruptcy than patients of a similar age without cancer – and patients who filed for bankruptcy had a 79 percent greater risk of early mortality than patients who did not. The authors concluded that cancer treatment increased the risk of financial catastrophes, which in turn are tied to cancer deaths.
- Healthcare sticker shock isn’t just for the seriously ill. Deductibles in job-based health plans in the U.S. have more than tripled in the last decade, which can leave patients reluctant to seek care for low acuity issues. A study from the Commonwealth Fund found 24 million Americans with employer health plans are struggling with high medical costs. As Commonwealth Fund vice president and study co-author Sara Collins told the Huffington Post, “They have higher rates of reporting not getting needed health care because of cost, not filling prescriptions, delaying going to the doctor or getting a follow-up visit.”
- 45 percent of Americans under 65 who have cardiovascular disease experience financial hardships from medical bills, according to another study. About one in three heart patients with healthcare-related financial hardship had to cut back on food or go without their required medications.
- Financial toxicity is associated with depression, anxiety and a drop in coping skills with cancer patients, particularly survivors under 40. One study found financially compromised patients with colorectal or lung cancer reported increased symptom burden and increased pain compared to patients with more financial reserves.
Three Telemedicine Cost Savings
The juggernaut that is the American healthcare system won’t be solved or dismantled anytime soon. But virtual care delivery offers several benefits that can help some patients avoid financial toxicity and find a path to better care outcomes.
- Telemedicine helps patients access care without sacrificing wages or paying for childcare or transportation. While those costs may seem minor in the context of a single visit, chronic illness can multiply them into a financial burden – such as weekly trips to a pediatric oncologist whose office is two hundred miles away or long absences from work that can impact earnings and promotions over time.
- Televisits can also divert patients from costly care settings like emergency departments (ED) and urgent care centers. Research shows telemedicine visits can generate cost savings for this reason, with the savings in one study ranging from $309 to more than $1,500 per eliminated ED visit.
- The same research showed telemedicine also encouraged patients to enter the healthcare system when they wouldn’t otherwise seek care. While this can initially increase utilization, it can also prevent more advanced and costlier treatment down the line, saving money for both patients and payers.
A toxic fog has long obscured the reality of healthcare costs and their impact on patient health. It’s time for greater transparency in our dialogues, from hospitals providing clear treatment price tags to patients discussing financial challenges with their doctors. But given that U.S. health expenditures will climb to almost $6 trillion by 2027, it’s also time to invest in innovation. Telemedicine can reduce costs and provide more affordable care. There has never been a better time or a greater need for the healthcare industry to go virtual.