A new report from PwC finds that health care spending will rise nine percent in 2027 at the same time that nearly half of Americans struggle to pay costs now. Insurers blame artificial intelligence tools and the cost of prescription drugs for this increase, Heather Landi reports for Fierce healthcare.
Hospitals and physicians have gotten better at submitting claims as a result of artificial intelligence, so insurers are less able to reject them for completeness or lack of detail. And, insurers must pay them more. Moreover, GLP-1 drugs for weight-loss and specialty drugs are driving up drug spending.
In addition, providers are consolidating, giving them more power to negotiate high reimbursement rates. And, more new drug treatments are high-cost with no lower-cost generic substitutes.
Sadly though not surprisingly, tens of millions of insured Americans are struggling all the more to pay for their health care, report Michael Karpman, Lisa Duvay et al. at the Urban Institute. The researchers looked at these three categories of people who had difficulty affording health care: 1. People who struggled to pay medical bills; 2. People who had skipped needed care during the last year because of costs; and, 3. People with medical debt.
Almost half of working people in the US–-46 percent–-struggled to pay their families’ health care costs last year. Nearly four in ten people with employer coverage, 39 percent, struggled with health care costs, and more than half of people with coverage through the state health insurance marketplaces, 53.8 percent. Fifty-seven percent of people with Medicaid struggled.
People living in the South and in rural America are most affected by high health care costs. And people in fair or poor health or who have a disability or chronic condition struggled more to afford needed care.
Here’s more from Just Care:
- Insurers drive up costs for people with diabetes
- AI is increasing health care costs
- Lower health insurance costs usually mean higher health care costs
- Poll: Costs remain a major barrier to care
- Public health insurance lowers health care costs and covers the care you need
