Price Anxiety is a Major Barrier for Patients. Here’s What We Can Do About It

Updated on February 14, 2024

A frightening trend is happening in healthcare affordability: It is now affecting a wider swath of US adults, including those who are squarely in the middle and upper middle class. 

Between the substantial increase in the monthly premiums and the larger out-of-pocket minimums for plan members, commercial healthcare is becoming unaffordable for almost everyone. This is having a significant impact on consumer healthcare behavior. 

People are avoiding routine care and testing which delays early-detection of chronic and serious conditions and results in people entering the care system sicker and often in later stages of chronic or serious illness. This creates a vicious economic cycle because higher levels of patient acuity (how ill a patient is when they enter the system) places a higher burden on the care system and increasing costs that eventually affects all patients. Coupled with the system-wide clinician shortage that makes it difficult for patients who do want care to get care, we have a perfect storm of conditions that suggest a substantially decreasing level of general population health. 

So how do we ensure that consumers are maintaining regular healthcare and screenings in this challenging healthcare economic climate? 

It will be critical that you take another look at your target patient population to fully understand how the economics are affecting them to determine the most effective solutions.

  • Understand where the new healthcare economics have the most impact on the patient journey – Patient journey work is more important than ever, not only to identify where in the journey that cost is having the most impact but also to uncouple the simultaneous care shortage challenge so that you are solving for the right problem at the right time. Are they behind on their routine screenings because they are worried about cost or because they can’t get it scheduled? It will also help you identify the blind spots you may have in how patients are reacting to the cost pressures and unexpected opportunities to intercede with support. 
  • Utilize behavioral segmentation to inform solutioning – There are a variety of behavioral principles that contribute to a patient delaying medical care – procrastination/present bias comes into play in the economic decision (e.g. prioritize mitigating the near-term financial burden over the vague, potentially negative future outcome); fear and anxiety; optimism bias that they won’t face serious health issues (more likely in younger patients); or stigma/shame. Knowing which are at play will help you create solutions that speak to their actual concerns. 
  • Solve the right problem and be creative – The more you understand about your customer, achieved by combining the unique opportunities identified in the journey with a behavior lens to understand patient motivation, the more creative  you will be in solutioning. For example, when it comes to economics, the default seems to be attempting to tell the story of why it will cost more to postpone treatment, but people who face economic challenges tend to discount potential future costs as less relevant or important than the real, current cost of a procedure that they need near-term. Instead, perhaps, you need to find solutions that ameliorate the immediate cost – lower-cost alternatives, financing support, etc. 

While each patient journey will vary slightly, the following themes can help make your strategies more effective. 

  • Infuse Cost Communication with Empathy – Financial concerns are a delicate subject for everyone, especially people who haven’t previously been challenged with it. Regardless of their situation, ensure that all patient communications are approached with empathy for the situation and the goal of empowering the patients to solve the problem.
  • Normalize Price Transparency – Currently the cost of care is rarely discussed with the patient when recommending tests or procedures. Getting estimates from the insurance company is often also a process because they frequently only share part of the cost picture or are unable to accurately quote the exact out of pocket cost for the patient. The extent to which you can change this within your realm of responsibility, will have direct increases in patient engagement.
  • Thoughtfully Embrace Lower Cost Solutions – Consider what lower cost options might be a good alternative for your patient. This could range from solutions like Mark Cuban’s Cost Plus Drugs, Cologuard over a colonoscopy (for the right patients), Grassroots Labs for reduced cost lab work, or even at-home monitoring tools. Myriad options are starting to emerge to answer these financial needs. 

Without significant changes to address the systemic issues driving increased healthcare costs, we can expect to be grappling with these for years to come. 

Investing now in understanding the impact to your patients and developing creative solutions within your realm of control is the best near-term approach to keeping patients engaged and healthy despite the challenges. 

Dave Norton Ph.D. is the Founder and Principal of Stone Mantel
Dave Norton, Ph.D.
Founder and Principal at Stone Mantel

Dave Norton, Ph.D. is the Founder and Principal of Stone Mantel, a research-led consultancy at the forefront of customer and employee experience strategy. With the support of lead experience strategists like Tiffany Mura, they guide, research, and build frameworks to help companies like Marriott, US Bank, Best Buy, and Clayton Homes deliver on Time Well Spent for customers and employees. Learn more at https://www.stonemantel.co/.

Tiffany Mura
Tiffany Mura
Lead Experience Strategist at Stone Mantel

Tiffany Mura is a lead experience strategist with Stone Mantel, a research-led consultancy at the forefront of customer and employee experience strategy.