Have you ever had the unfortune of getting out of the hospital and later receiving a medical bill for which you were completely unprepared? Even if you have health insurance – which many people in the United States still do not – navigating the ins and outs of medical insurance can be a challenge for even the most well-versed patient. New research published in JNCI Cancer Spectrum takes a closer look at this topic in a recent study examining how medical financial hardship and non-medical financial sacrifices among adult cancer survivors is related to health insurance literacy.
The study comes from the American Cancer Society and was headed by Jingxuan Zhao, MPH of the ACS. In the study, Zhao and fellow researchers used data from 914 adult cancer survivors who had filled out the 2016 Medical Expenditure Panel Survey Experiences with Cancer self-administered questionnaire. The questionnaire is a national survey measuring health insurance literacy in which patients respond to questions such as, "Did you ever have a problem understanding health insurance or medical bills related to your cancer, its treatment, or the lasting effects of that treatment?" Other questions related to financial hardship, health insurance coverage, and access to care related to cancer, its treatment, and lasting effects of treatment are also included in the survey.
(For the purposes of the survey, medical financial hardship is defined as having difficulties paying medical bills, concern about the ability to pay medical bills, and or delaying or foregoing care because of cost. Meanwhile, the survey considers non-medical financial sacrifices as those such as changes in spending, living situation, or use of savings.)
The researchers’ analysis determined that 18.9% of adult cancer survivors between the ages 18-64 years and 14.6% of those older than 65 years reported health insurance literacy problems. As the authors write, “In both age groups, survivors with health insurance literacy problems were more likely to report any material or psychological hardship, as well as all types of non-medical financial sacrifices than those without the problems.”
"Growing evidence suggests that health insurance literacy is a nationwide problem in the United States, and is associated with adverse effects," continue the authors. “Interventions such as financial and health insurance navigation, decision aids, and more user-friendly and easier-to-read medical bills, which improve patients' understanding of health insurance and medical costs, could potentially be applied to improve health insurance literacy and benefit cancer survivors."
The authors hold out hope that such types of interventions could help relieve the economic stress that many cancer survivors, as well as other kinds of patients, undergo. They aim to continue their investigations with longitudinal studies in the future.