DUBLIN, Sept. 21, 2023 /PRNewswire/ -- The "Out of Pocket Spending in Healthcare,(Pharmaceuticals, Surgeries, Tests, Electives, Premiums, Copays, Doctor Visits, Other), 6th Edition" report has been added to
ResearchAndMarkets.com's offering.
The report examines past, current, and future levels of U.S. out-of-pocket healthcare expenditures both in total and as specific sub-groups (by type, by payment method, by elective vs. non-elective).
A variety of demographic, business, and government trends are contributing to rising out-of-pocket (OOP) healthcare expenses in the United States. The report examines these trends in detail, focusing on the financial aspects of OOP spending growth and quantifying the growth of OOP spending with forecasts of total expenditures and specialized healthcare financing.
Through the next five years, total consumer out-of-pocket expenditures for healthcare are expected to continue rising, with trends established over the past several years continuing through the foreseeable future.
While the Covid pandemic of 2020 and 2021 caused a temporary pullback in consumer out-of-pocket healthcare spending, the historic trend resumed in 2022 and is expected to continue through the five year forecast period of this report. Types and Amounts of Expenses Financed
In 2023, U.S. consumers financed many different types of healthcare expenses. These can broadly be grouped into two categories: elective procedures including over-the-counter (OTC) medications and non-elective procedures including prescription drugs. These types of procedures are distinct and discussed separately within the report.
Elective procedures are those that are not strictly necessary to address a medical condition. They are thus not covered by medical insurance and their utilization is discretionary on the part of the consumer. The amount of non-elective healthcare and prescription drug expenses financed by individual consumers varies widely, although a very large proportion of consumers must finance some expenditures.
Consumers Who Pay Out-Of-Pocket
Consumers from all socioeconomic groups are facing high out-of-pocket expenditures for healthcare. Certain groups are more vulnerable than others to having trouble paying their medical bills and represent a larger proportion of this spending.
These include the uninsured and underinsured, Medicaid recipients, disabled persons, senior citizens, the mentally ill, obese persons, people suffering from drug or alcohol addiction, persons with chronic medical conditions.
Expenditures by Type, Payment Methods, Elective vs. Non-Elective Procedures
Consumers in the United States utilize a variety of methods to pay for healthcare products and services, required in instances when payment is not made directly from a healthcare plan to the provider.
The report examines expenditure by type, including direct payments and co-pays, and illustrates that the amount of out-of-pocket expenditures financed by consumers in the coming years will vary considerably between elective and non-elective procedures.
Market Drivers and Restraints
The strong growth in U.S. out-of-pocket spending is the result of a preponderance of market drivers, which are mitigated by relatively few market restraints.
A large number of companies help consumers pay their out-of-pocket medical expenses and/or significantly influence those expenses. Most companies that provide patient financing focus on funding elective procedures, with a smaller number offering financing for non-elective therapies and providing other financial services.
While companies participating in the credit card, and lines/lines of credit segment are numerous and do not specialize in healthcare products, the companies operating in the specialized healthcare financing are highly focused on financing medical and dental expenses. In general, the market is very dynamic, with many players entering and exiting.
Lending Club Patient Solutions
Prosper Healthcare Lending
SimpleSelect Patient Finance
Chapter 1: Executive Summary
Out-of-Pocket Expenditures in the U.S. Healthcare Industry
Out-of-Pocket Spending Summary
Health Care Financing Programs, HSAs, Loans or Lines of Credit) (%)
Chapter 2: The U.S. Healthcare System in 2023
Healthcare System Overview
Children's Health Insurance Program
Commercial Health Insurers
Blue Cross Blue Shield Plans
Self-Funded Employee Health Plans
Insufficient Focus on Wellness and Prevention
U.S. Costs vs. Peer Country Costs
High Cost Variation by City and Venue
Managed Care Cost Shifting
System Errors and Inefficiencies
The Effect of the Economy
Discontinued Stimulus Payments
Replacement of Workers by Technology
Disease Management and Wellness Programs
MACRA and Value Based Reimbursement
Payment for Approved Assays
Consumer Healthcare Information
Consumer Information Online
Personal Health Records (PHRs)
Private-Label OTC Medications
Individual Mandate Repeal
Short Term Limited Duration Insurance (STLDI)
Impact of the ACA on Out-of-pocket Expenditures
Chapter 3: U.S. Out-of-Pocket Expenditures
High Deductible Health Plans
Cash, Check or Money Transfer
Loans and Lines of Credit
Flexible Spending Accounts
Types and Amounts of Expenses Financed
Elective Procedures and OTC Medications
Non-Elective Procedures and Prescription Drugs
Consumers Who Pay Out-Of-Pocket
The Uninsured and Underinsured
Persons with Alcohol and Drug Addictions
Persons with Chronic Conditions
Chapter 4: Consumer Out-of-Pocket Spending Forecasts in the U.S.
Total Financing of Elective vs. Non-Elective Procedures
Chapter 5: Specialized Healthcare Financing
Types of Procedures Financed
Chapter 6: Specialized Healthcare Financing Forecasts
Leading Providers of Specialized Healthcare Financing, by Company (Ally, CareCredit, ClearBalance, ClearGage, GreenSky, Lending Club, Lending USA, Prosper Healthcare, Wells Fargo, Others), 2022 ($ Billion) Market Positions of Leading Providers of Specialized Healthcare Financing, by Company (Ally, CareCredit, ClearBalance, ClearGage, GreenSky, Lending Club, Lending USA, Prosper Healthcare, Wells Fargo, Others), 2022 (%) Chapter 7: Efforts to Contain Out-of-Pocket Spending
Consumer Groups, Community Organizations and Others
Chapter 8: Company Profiles
History and Lines of Business
Relevant Business Operations
For more information about this report visit https://www.researchandmarkets.com/r/e1xvja
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