Most Doctors' Offices Don't Offer Flexibility for Uninsured

Most uninsured patients can make primary care appointment but only if can pay full cash amount

MONDAY, April 16, 2018 (HealthDay News) -- Most physician offices do not offer up-front payment flexibility or low-income discounts to uninsured people, according to a study published in the April issue of Health Affairs.

Brendan Saloner, Ph.D., from Johns Hopkins University in Baltimore, and colleagues had trained auditors call primary care offices (2012-2013 and 2016), including federally qualified health centers, in 10 states. The auditors, pretending to be uninsured patients, sought appointments and information on the cost of care and payment arrangements.

The researchers found that in both time periods, about 80 percent of uninsured callers received appointments, provided they could pay the full cash amount. However, in both time periods fewer than one in seven callers received appointments for which they could make a payment arrangement to bring less than the full amount to the visit. For both time periods, the average price was about $160. Federally qualified health centers provided the highest rates of primary care appointment availability and discounts. Despite varying changes in the uninsurance rate, trends were similar across states.

"Although the uninsured population has decreased under the Affordable Care Act, the challenges encountered by the remaining uninsured persist," the authors write.

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