Story at a glance
- Older Americans face a heightened risk of economic insecurity.
- New research shows the majority of those between the ages 50 and 80 are at least somewhat concerned about the cost of an emergency medical visit.
- In the past two years, 22 percent who may have needed emergency care did not seek it due to cost concerns.
Cost concerns prevent more than 20 percent of Americans between the ages 50 and 80 from seeking emergency medical care even when they think they may need it, according to a new study.
Of the more than 2,000 older Americans surveyed, most reported concerns about the costs of emergency department visits. Individuals in their 50s and early 60s, women, those who lack health insurance, people with household incomes below $30,000 and those who say their mental health is fair or poor were most likely to say they’d skip emergency care due to cost.
The new research was published in The American Journal of Managed Care.
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COVID-19 put strains on many Americans’ household finances, authors wrote, and data show out-of-pocket health spending in 2022 grew at the highest rate recorded since 1985.
Respondents completed the survey in June of 2020 and were prompted to think back to the previous two years and first few months of the COVID-19 pandemic.
Four out of 5 adults who hadn’t had a medical emergency during this window said they were concerned about the cost of emergency care, with 45 percent saying they were very concerned about it. Eighteen percent said they were not confident they could afford a visit to the emergency department.
“As an emergency physician, I have seen patients come to the emergency room having postponed their care. They often come in sicker than they would have been had they received care sooner,” lead author Rachel Solnick, of the Icahn School of Medicine at Mount Sinai Health System in New York, said in a release.
“That scenario is what I find most alarming in this survey’s findings. Some groups that are medically vulnerable or have suffered worse outcomes from COVID-19 were more likely to report cost-related avoidance of the [emergency room] than their counterparts. These findings highlight the importance of reducing the number of uninsured individuals and the need for insurers to clearly communicate coverage for emergency services.”
Older Americans face a greater risk of economic insecurity, authors wrote. Previous research has found around half can’t afford essential expenses. Those factors can make it more difficult for these Americans to absorb unexpected health costs.
Furthermore, as the number of older adults in the country increases, so too will emergency department visits, putting more demand on an already strained U.S. health care system.
The study was carried out prior to the passage of the No Surprises Act, which aims to curb surprise billing for emergency care when a privately insured individual receives care from outside of their network. However, the law doesn’t address other sources of high health care costs, like in-network deductibles, authors noted.
In addition, older Americans may be covered by Medicare or Medicaid, which already ban the form of billing addressed in the No Surprises Act.
But “coupled with increased cost concerns in those aged 50 to 64 years, we find that the financial impact of emergency care remains a salient concern for older Americans who have not yet reached the age of Medicare eligibility and do not meet the income thresholds of Medicaid,” researchers said.
Although just 4 percent of study participants were uninsured, these individuals were 35 percent more likely to say they were not confident they could afford emergency department care.
Researchers suggest future policies help reduce out-of-pocket spending for this vulnerable population.
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