More chronic diseases lead to more medical debt

Nearly a third of patients with seven or more chronic conditions face medical debt compared to 7.6% for those without chronic conditions.

According published study in JAMA internal medicine.

The research used medical claims data from adults enrolled in Blue Cross Blue Shield of Michigan from January 2019 to January 2021 and linked it to trade credit data in January 2021.

Of the 2.85 million adults studied, the predicted odds of having medical debt, non-medical debt, delinquent debt, low credit score, or recent bankruptcy were all significantly higher when more chronic conditions were present.

People with 7 to 13 chronic conditions had medical debt 32% of the time, compared to 7.6% for those without. The gap between the two groups was also wide and highly skewed for adults with seven or more chronic conditions for non-medical debt (24% versus 7.2%), overdue debt (43% versus 14 %), a low credit score (47% to 17%), and recent bankruptcies (1.7% to 0.4%).

Among those with medical debt, the estimated amount increased with the number of chronic conditions, from $784 for those with no chronic conditions to $1,252 for those with seven or more.

Related: 23 Million Americans Have ‘Significant’ Medical Debt

The results showed significant variation between each chronic condition and its risk of creating medical debt. The chronic conditions associated with the largest adjusted increases in medical debt were serious mental illness ($274), substance use disorder ($268), stroke ($235), heart failure congestive ($234) and liver disease ($228).

The study notes that the variation between conditions could suggest that some conditions are more costly to treat with higher out-of-pocket expenses, while others may result in an individual’s inability to work and earn an income.

Either way, research findings show that poorer financial health is associated with poorer physical and mental health outcomes.

“If poor financial well-being leads to additional chronic diseases, policymakers should consider new social safety net policies to reduce poverty rates and should explicitly incorporate improvements in physical health – and as a result reduction in health expenditure – as a benefit of anti-poverty programs,” the study concludes.

“If, on the other hand, chronic disease diagnoses directly lead to adverse financial outcomes, then improved commercial insurance benefit design would be warranted to provide additional protection against out-of-pocket medical expenses, particularly for the conditions identified. as being costly for patients.

The consequences of patients accumulating debt are also straining care providers.

According to a Crowe Revenue Cycle Analytics reporthospital recoveries drop significantly when disbursements reach $7,500.

Reports from patients with balances over $7,500 have only increased in recent years, from 5.2% in 2018 to 17.7% in 2021.

Jay Asser is associate editor for HealthLeaders.


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John A. Bogar