Nav: Home

Survey: Seriously ill Medicare beneficiaries can face considerable financial hardship

November 04, 2019

Boston, MA--Despite high beneficiary satisfaction with Medicare overall, a new national survey led by researchers from Harvard T.H. Chan School of Public Health, Harvard Business School, and colleagues finds that its coverage gaps may cause considerable financial distress for the most seriously ill patients. About half reported a significant problem paying medical bills, with prescription drugs posing the most hardship.

This paper is part of a larger study conducted by Harvard T.H. Chan School of Public Health, the New York Times, and the Commonwealth Fund. It will be published online November 4, 2019 in Health Affairs.

"What stands out here are the extensive financial problems many seriously ill Medicare beneficiaries face paying for their prescription drugs today," said principal investigator and co-author Robert Blendon, Richard L. Menschel Professor of Public Health and Professor of Health Policy and Political Analysis at Harvard Chan School and director of the Harvard Opinion Research Project.

The researchers analyzed survey data collected by phone between July 6-August 18, 2018. The sample included 742 Medicare beneficiaries defined as seriously ill, meaning they had illnesses requiring recent hospitalizations or multiple physician visits.

Among the respondents, 53% reported having a serious problem paying a medical bill of any kind, with 30% reporting difficulty paying for prescription drugs, followed by hospital bills (25%). Beneficiaries also reported experiencing financial hardships due to the costs of their illness, including using up all or most of their savings (36%) and being unable to pay for necessities such as food, heat, and housing (23%). Emotional or psychological distress was reported by 45% of respondents.

The authors write that while Medicare is perceived to offer good financial protection compared with commercial insurance, the extent of financial strain among seriously ill beneficiaries was notable and warrants further investigation. They note that while high-need, high-cost patients are associated with acute and end-of-life care, the majority of beneficiaries in this survey sample were living at home, relying on informal help from family and friends--at considerable cost to themselves and their caretakers.

"In addition to financial strain, the survey indicates potential opportunities to improve care delivery for complex patients," said Michael Anne Kyle, first author of the study and a doctoral student at Harvard Business School. "Medicare beneficiaries with serious illnesses described challenges ranging from the demands of informal caregiving to issues as fundamental as understanding a medical bill."
-end-
John Benson, research scientist in the Department of Health Policy and Management at Harvard Chan School, was a co-author.

This study was funded by the Commonwealth Fund (Grant No. 20181608).

"Financial Hardships of Medicare Beneficiaries With Serious Illness," Michael Anne Kyle, Robert J. Blendon, John M. Benson, Melinda K. Abrams, Eric C. Schneider, Health Affairs, online November 4, 2019, doi: 10.1377/hlthaff.2019.00362

Visit the Harvard Chan School website for the latest news, press releases, and multimedia offerings.

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people's lives--not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America's oldest professional training program in public health.

Founded in 1908 as part of Harvard University, Harvard Business School is located on a 40-acre campus in Boston. Its faculty of more than 200 offers full-time programs leading to the MBA and doctoral degrees, as well as more than 70 open enrollment Executive Education programs and 55 custom programs, and Harvard Business School Online, the School's digital learning platform. For more than a century, HBS faculty have drawn on their research, their experience in working with organizations worldwide, and their passion for teaching to educate leaders who make a difference in the world, shaping the practice of business and entrepreneurship around the globe.

Harvard T.H. Chan School of Public Health

Related Public Health Articles:

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.
The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.
The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.
The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.
The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
More Public Health News and Public Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.