financial wellness
Preventive care is free by law, but many Americans get incorrectly billed − especially if you’re poor, a person of color or don’t have a college degree
Preventive care costs exacerbate health disparities, disproportionately affecting marginalized communities. Insurance claim denials are higher for minority and low-income patients despite legal exemptions.
Alex Hoagland, University of Toronto and Michal Horný, UMass Amherst
Even though preventive care is supposed to be free by law for millions of Americans thanks to the Affordable Care Act, many don’t receive recommended preventive services, especially racial and ethnic minorities and other at-risk patient groups.
The Affordable Care Act exempted preventive services from patient cost-sharing for large chunks of the population. This means that if you receive preventive screening and have private insurance, including through the ACA Marketplace, there should be no copay at time of service, and you shouldn’t get a bill later on. Easy enough, right?
Wrong. Our team of health economists has shown that patients spend millions of dollars every year on unexpected bills for preventive care. The main reason for this is that no specific regulations were put in place to determine exactly which services should be exempted, or for whom, or how often. This omission has left many people on the hook to pay for valuable health care they thought would be free.
Now, in our recently published research in the journal JAMA Network Open, we’ve found that the burden of paying for what should be free preventive care disproportionately falls on some patient groups.
Inequitable claim denials
Looking at data from over 1.5 million patients, our study demonstrates that insurers deny preventive claims for patients from marginalized communities at higher rates than for those from majority groups.
For example, low-income patients were 43% more likely than high-income patients to have their claims denied. In addition, Asian, Hispanic and non-Hispanic Black patients were each roughly twice as likely as non-Hispanic white patients to have claims denied.
Not only were these patients denied routine benefits, but they also saw large differences in rates of billing errors. For example, patients with a high school diploma or less experienced denials due to this kind of billing error almost twice as often than patients with college degrees. All of these services should have been covered by an insurer.
Research on preventive care access is commonly based only on claims data, which doesn’t typically have information on patient demographics. This limits a study’s ability to detect differences across patient groups. Our study, however, uses a combination of linked claims data, remittance data containing information on why claims were denied and whether they were resubmitted, and demographic data from self-reports, purchase transactions and voter registries. Together, this richer dataset allowed us to examine differences in denials based on race and ethnicity, education and income, including reasons why patients were denied care.
Preventive care is essential
Equitable access to preventive health care is about more than just physicals, although those are important, too. Preventive health care includes key screenings for cancers, cardiovascular disease and diabetes, access to contraceptives, and mental health checkups, among other services. Ensuring that insurers provide equal coverage for these services for all patients is important to improve health outcomes and quality of life for everyone while reducing future health care costs.
Our results paint a picture of the kinds of hurdles patients face when they seek health screenings. Patients from underrepresented groups were not only more likely to be told their care wouldn’t be covered. They were also more likely to have their claims processed incorrectly, leading to more frequent denials and, ultimately, larger medical bills. https://www.youtube.com/embed/Uc2uG6LhFQQ?wmode=transparent&start=0 Few patients appeal claim denials, even though rejections may be unjustified.
Unexpected bills can affect both a patient’s current health and their future use of health care services. These hurdles can exacerbate an already tenuous trust in a fragmented health care system, making patients less likely to return for follow-up screenings.
Stacked coverage denials for patients who live with multiple marginalized identities or who are less able to advocate for themselves can further entrench racial and socioeconomic inequities.
Ensuring equitable access
Our study paints a compelling picture of where different patients may face hurdles for getting preventive care, but more research is necessary to identify how to ensure equitable access.
As our study looked only at preventive services, we will also need to see how our findings generalize to other forms of health care. More research is also needed to understand how other vulnerable patient groups, such as LGBTQ+ patients or patients with multiple chronic conditions, fare when trying to access care.
Our team is currently studying how actual bills for care differ across patient groups and how patients respond when bills arrive. In our study, more than two-thirds of denied claims were never resubmitted to insurers, meaning that many billing errors go uncorrected at patients’ expense.
Equitable policy on multiple fronts can help rectify the way preventive care is inconsistently and inequitably provided. These include uniform coverage of preventive care by insurers, standardized billing practices for physicians and improved means for patients to advocate for themselves. This can help ensure that everyone has appropriate access to lifesaving health care.
Alex Hoagland, Assistant Professor of Health Economics, University of Toronto and Michal Horný, Assistant Professor of Health Policy and Management, UMass Amherst
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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(Family Features) Saving money is a critical financial practice that nearly everyone strives to accomplish. Yet, it is often easier in theory than reality. If you are anxious or concerned about your financial situation and your ability to save, know you’re not alone.
More than one-third (36%) of the general U.S. population feels anxious about their current financial situation. Further, many households across the country do not feel in control of their finances, with 11% reporting they’ve “forfeited contributions to their retirement accounts,” potentially impacting themselves later in life. These figures from the World Financial Group paint a concerning picture of how people across the country feel about their current and future finances.
Consider these savings tips.
Create a Budget
Every budget begins with your net income. Ensure you subtract deductions like taxes, workplace benefits, insurance or retirement plan contributions. This way, you know exactly how much money is available each month. Next, calculate all fixed expenses, including regular monthly payments or bills. These include utilities, cellphone bills, rent or mortgage, vehicle payments and anything that remains static month-to-month. Subtract those fixed expenses from your net income to create your monthly budget.
Track Your Expenses
Once your budget is in place, it’s much easier to keep track of expenses that vary month-to-month, like gas, groceries and entertainment costs such as dining out, seeing a movie or going to a sporting event. Tracking minor expenses may seem tedious initially, but logging each purchase can help set a foundation for financial accountability.
Set Savings Goals
Tracking your expenses for a few months should give you a good idea of how realistic it is to save a set amount of money each month. Before you set a goal, or if you’re struggling to consistently reach savings goals, take a financial literacy quiz to test your knowledge and then consider meeting with a financial services expert.
Pay Down Debts
Debt is one of the largest barricades people face when trying to save more money. If you feel debts are stopping you from reaching your financial goals, know it is possible to pay off debt while saving at the same time. Make sure to prioritize debts with higher interest rates that lead to compounding costs in the future and then, if possible, make more than the minimum payment to pay them off faster. It may limit you in the short-term but can equate to more financial freedom – and the ability to save more – in the future.
Find more expert savings advice and test your financial literacy by visiting WorldFinancialGroup.com.
Photo courtesy of iStock
SOURCE:
World Financial Group
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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Community
The Hidden Harm of Civil Legal Issues: A path to help Americans in need
Many Americans face unresolved civil legal issues, often unaware of available assistance, leading to disadvantages in legal systems despite the existence of free help from legal aid organizations.
Civil Legal Issues
(Family Features) Your landlord is threatening to evict you, while maintenance issues in your apartment complex have been ignored, making it difficult to get to work and pay the bills. That’s a civil legal issue.
You know you’re qualified for Veterans or Social Security benefits, but you can’t seem to get through the red tape. That’s a civil legal issue.
The mobile home park where you lease a space for your manufactured home is kicking you out, and you may lose your investment in the home as well as a place to live. That’s a civil legal issue.
A survey from the Legal Services Corporation (LSC) found many Americans who experienced a civil legal matter within the past three years (59%) didn’t seek legal help from an attorney who could have been pivotal in getting their issues resolved.
A misunderstanding found in the survey is that more than half of American adults (56%) wrongly believe they have a right to a lawyer in a civil case. In fact, Americans only have a right to a lawyer when they have been accused of a crime. This misperception means some people may end up in civil court at a big disadvantage in a complex legal system because they don’t have legal representation.
Civil legal issues can be life-changing. Even though people do not have a right to a lawyer in these cases, free help is available for many low-income people who cannot afford to hire a lawyer. Celebrating its 50th anniversary this year, LSC supports 130 independent, nonprofit legal aid programs in every state, the District of Columbia and the territories. It launched the Protecting the Promise outreach campaign, aimed at ensuring legal aid is available to low-income Americans who need it.
Legal aid attorneys help with the most common civil legal issues people in the national survey said they faced in the last three years, even if they didn’t recognize them as legal issues. Those were debt collection (63%), job loss (56%) and issues surrounding natural disasters (52%).
In addition to these issues, legal aid organizations supported by LSC also help with family law issues like divorce, child custody and domestic violence.
Many Americans don’t realize when they could benefit from legal assistance. A significant portion of Americans (1 in 3) who didn’t seek legal help for civil matters in the past three years said they thought they could deal with the problem on their own or didn’t think the problem was serious enough for legal help. Additionally, almost one-quarter didn’t reach out for legal assistance because they didn’t think an attorney could help with their problems.
More than three-quarters of women didn’t seek legal help when contacted by creditors or collection agencies compared to fewer than half of men who didn’t seek help.
Money is a big barrier. Among those who did not seek legal assistance, nearly one-third did not do so because they were worried about the cost.
Unresolved civil legal issues can pile up, hurting individuals, families and even entire communities. For people with low incomes, getting help can be difficult. Hiring a lawyer can be expensive, and most people don’t know where to start.
To see if you’re eligible for civil legal aid or to find a legal aid organization in your area, visit lsc.gov.
Photos courtesy of Shutterstock
SOURCE:
Legal Services Corporation
The Bridge is a section of the STM Daily News Blog meant for diversity, offering real news stories about bona fide community efforts to perpetuate a greater good. The purpose of The Bridge is to connect the divides that separate us, fostering understanding and empathy among different groups. By highlighting positive initiatives and inspirational actions, The Bridge aims to create a sense of unity and shared purpose. This section brings to light stories of individuals and organizations working tirelessly to promote inclusivity, equality, and mutual respect. Through these narratives, readers are encouraged to appreciate the richness of diverse perspectives and to participate actively in building stronger, more cohesive communities.
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(Family Features) Being financially secure in retirement starts while you’re still working. Because you likely don’t want to remain in the workforce forever, creating a plan can help ensure you’re confident in living comfortably in retirement when the time comes.
Retirement plans and financial aspirations are deeply personal and often tied to family life, ambitions and values, meaning it’s entirely up to you when to start planning and saving for your post-work years. However, the worrying reality is that many households across the U.S. don’t feel in control of their finances. According to a study from World Financial Group, 11% of households have “forfeited contributions to their retirement accounts,” a decision that will have an impact later in life.
To ensure you’re prepared, consider these steps to plan for retirement.
Understand When You Can Retire and How Much Money You Will Need
Because nearly everyone has different goals for retirement, there’s no one-size-fits-all approach to when and how much money you’ll need to stop working. Assess your unique situation – including all your forms of income, assets and savings – and calculate what you’ll need to maintain your standard of living and cover expenses, including any discretionary spending, in retirement.
Choose an Appropriate Retirement Plan for Your Needs
In addition to figuring out how much you should save, having the right savings vehicle is an important consideration. A good place to start is an employer-sponsored retirement plan with fund-matching, such as a 401(k). If a workplace retirement plan is not available, consider setting aside money for retirement through an IRA that provides access to a range of investments, including stocks, bonds and mutual funds. Some insurance products may also provide benefits during retirement, such as life insurance coverage, supplemental income and tax advantages.
Take Stock of Your Current Assets
Your current assets include more than just what’s in your bank account. Beyond your paycheck, factor in real estate, investment accounts and any insurance policies you may have. If you need help understanding your finances, take a financial literacy quiz to test your knowledge and then consider meeting with a financial services expert.
Create a Retirement Budget and Look at Ways to Reduce Expenses
Your retirement budget should look similar to yours while still part of the workforce. Start by accounting for how much money is coming in and how much is going out toward fixed expenses like utilities, cellphone bills, insurance premiums, rent or mortgage and vehicle payments then track other expenses like groceries, gasoline and other spending toward non-essentials like entertainment and clothing. From there, look for ways to cut expenses to stretch your funds further, such as canceling a streaming service, dining out less or skipping a new movie release.
Account for Unexpected Expenses
Before retirement, consider how you’d handle unexpected expenses such as a medical emergency, home or vehicle repair or moving into an assisted living facility. Suppose you don’t have the appropriate health and homeowner’s insurance coverage. In that case, you may be covering those costs out-of-pocket, which could limit or hinder your financial flexibility on a fixed income.
Test your literacy and find additional resources to plan for retirement at WorldFinancialGroup.com.
Photo courtesy of iStock
SOURCE:
World Financial Group
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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