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For too many Americans, simply having health insurance isn’t enough to afford and access the care they need. Our inaugural Patient Experience Survey (PES) reveals how rising out-of-pocket costs can exacerbate affordability issues and hinder access to care. This especially holds true for the sickest and most vulnerable patients.

Here are four things you should know.

1. 3 in 10 Americans who have insurance still face a financial barrier to care, including trouble paying medical bills or other out-of-pocket costs. Simply having health insurance coverage is not always enough for Americans to afford their care.

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2. Hospital bills cause the most financial strain and concern. 30% of Americans with problems paying medical bills in the past year say hospital bills were the largest share of these costs. Moreover, 24% of Americans would be “very worried” about their ability to pay for hospital bills.

3. Americans report difficulty paying insurer out-of-pocket costs, such as deductibles and coinsurance, which can lead people to abandon their medicines. More than half (52%) of patients with a high-deductible health plan report not taking their medicines as prescribed by their doctor in the past year (also known as non-adherence). And 87% of Americans with medical debt report nonadherence in the past year.

4. The most vulnerable patients are more likely to experience several barriers to access at once. 31% of Americans reporting poor health and 26% of patients with disabilities report forgoing needed care, have trouble paying medical bills, have out-of-pocket costs that are more than they can afford, have no savings to cover medical expenses and worry about accessing and paying for care.

Insurance should work like insurance. When it comes to solutions, a majority of patients (59%) prioritize lowering out-of-pocket costs over their premiums. We need solutions that make insurance work like insurance by covering more medicines from day one, making out-of-pocket costs more predictable, ensuring cost-sharing assistance applies to deductibles and sharing negotiated savings with patients at the pharmacy counter. Read the full Patient Experience Survey here and learn more about patient-centered solutions at PhRMA.org/BetterWay.

Cynthia Hicks

Cynthia Hicks is Senior Director of Public Affairs at PhRMA focusing on polling and opinion research that supports advocacy communications and strategy. Prior to joining PhRMA, Cynthia worked as a consultant, marketer, and head of polling for a civic technology company where her work supported issue advocacy organizations and policy makers on both sides of the aisle. Cynthia is a proud Los Angeles native and outside of the office she enjoys an early morning HIIT workout and spending time with friends and family.

Cynthia Hicks

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New study shows why insurers should share rebates with Medicare Part D beneficiaries on a mandatory basis

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January 25, 2019

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January 22, 2019

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January 2, 2019

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69 percent of patients abandon medicines when cost sharing is more than $250

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Medicare Part D cliff ahead

June 21, 2018

Patients with a deductible have seen their out-of-pocket costs for brand medicines increase 50 percent since 2014

June 20, 2018

Part D cliff looms for seniors, as program stability could be in jeopardy

June 18, 2018

ICYMI: Analysis finds higher outpatient drug spending at 340B hospitals

June 18, 2018

Event tomorrow: Improving patient access to lifesaving medicines

May 22, 2018

Sharing negotiated discounts at the pharmacy counter could save seniors with diabetes more than $350 annually

May 17, 2018

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May 9, 2018

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May 4, 2018

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May 2, 2018

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April 25, 2018

Patients pay the price when hospitals mark up cancer medicines

April 5, 2018

Advance price notification: A transparency measure that fails patients

March 29, 2018

New Let’s Talk About Cost ads highlight how copay accumulator programs could leave patients financially exposed

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ICYMI: Research shows promise of innovative payment arrangements in reducing costs, improving access

March 15, 2018

ICYMI: Two PBM reports show dramatic slowdown in medicine spending growth

March 2, 2018

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