NCPA - National Center for Policy Analysis

Help for the Nonmedically Indigent Uninsured

December 1, 2003

Private practitioners provide five times as many visits for the uninsured as safety-net institutions, such as emergency departments and community health centers, provide, say researchers.

A recent study that examined the care uninsured patients in general internists' private practices received found that more than two-thirds of internists provide at least some charity care, usually to their existing patients who have become uninsured:

  • Uninsured patients represent on average only 9 percent of private office-based providers' visit load, but because there are many private practitioners, the aggregate number of visits for uninsured patient is commensurately large.
  • Because the average charge for a routine office visit is $64, with 75 percent of internist charging between $45 and $85 many uninsured patients have trouble affording a visit if they are facing financial difficulties.
  • If the patient is uninsured and has trouble paying for the visit, 65 percent of internists reduce the customary fee or charge nothing; in addition, most internists will accept partial payment at the time of the visit or bill later, only 25 percent ask for full payment at the time of a visit.
  • More than two-thirds of internists will create a payment plan; if the bill is not paid, more than a third will write off the charge.
  • Fifty-two percent of internists report that their uninsured patients are mostly established patients who lost their insurance; 10 percent report their uninsured are a mixture of new and established patients, while 33 percent reported that their patient population consisted mostly of new patients.

Providing care to uninsured patients who are not medically indigent but rather, because of job loss or other circumstance, have lost their health insurance is an important service, especially with rising unemployment rates, say the authors.

Source: Gerry Fairbrother et al., "Care for he Uninsured in General Internists' Private Offices," Health Affairs, November/December 2003.

 

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