Healthcare News of Note: Trust in local healthcare systems’ handling of the pandemic increased during a 28-month time span

• The proportion of people reporting trust in their local hospitals and health systems increased significantly between April 2020 and August 2022, according to results of a study
• Out-of-pocket costs after hospitalization for traumatic injury exceed the ability of many commercially insured patients to pay and could be associated with bankruptcy risk.
• Between 2013 and 2020, deaths involving cocaine nearly quadrupled, and deaths involving psychostimulants (primarily methamphetamine) more than sextupled.

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.    

1. Trust increased in healthcare providers’ handling of the pandemic but fell for federal, state and local government efforts

Findings from NRC Health’s national Market Insights study, released Nov. 1, show that “people trust local hospitals and health systems far more than they trust federal, state, and local government to handle the COVID-19 pandemic.”

“The pandemic challenged the healthcare industry dramatically, but even in light of unprecedented circumstances, trust in hospitals and healthcare systems rose significantly during the pandemic,” wrote the study authors. Specifically, “the proportion of people reporting trust in their local hospitals and health systems increased” from 20.7% in April 2020 to 35.8% in August 2022, according to data based on responses from 682,217 consumers.

However, not all feedback indicates the same positive assessments of the U.S. healthcare system. Consider “Restoring Trust in Healthcare,” a deep dive into the topic and the first 2022 piece of HFMA’s Healthcare 2030 series. The report states: “Since the COVID-19 pandemic emerged, the level of trust in the healthcare ecosystem has grown more volatile, research shows, with race and ethnicity, income level and gender impacting the level of trust.”

In the HFMA report, article author Jeni Williams writes: “Nearly half of U.S. consumers say they are less confident in the healthcare system’s ability to manage major health crises than they were before the pandemic, according to the 2022 Edelman Trust Barometer. Fifty-five percent say a negative healthcare experience caused them to lose trust in their healthcare provider, another survey found, while more than a third of respondents had skipped care because they did not like the way they were treated by a healthcare provider.”

NRC Health’s study reviewed consumer trust in healthcare providers and in various levels of government. The NRC study found “the proportion [of people] who trust the federal government to handle the pandemic declined from 10.6% in April 2020 to below 10% in every subsequent month until rebounding in May 2022 and reaching 13.2% in August 2022,” wrote the authors. “Trust in state government dropped from 13.8% to 7.2%, while trust in local government hovered in the 5% range during the study period.”

2.  Admission for traumatic injury causes financial woes for working-age adults with commercial insurance

“Admission for traumatic injury was associated with higher rates and amounts of medical debt in collections and a doubling of bankruptcy filings among commercially insured working-age adults,” according to results of a study published Nov. 11 in JAMA Health Forum.

The out-of-pocket (OOP) costs after hospitalization for traumatic injury exceed the ability of many commercially insured patients to pay and “could be associated with bankruptcy risk,” wrote the authors.

Study results

Relative to a comparison cohort in the study, the postinjury cohort had:  

• A 23% higher likelihood of having medical debt in collections
• A 70% higher amount of medical debt in collections
• A 110% higher bankruptcy rate

The JAMA article quoted the results of a study of commercially insured adults published in the Annals of Surgery in March, which “found that the average OOP payments in the year after traumatic injury” were $3,400, and approximately $5,000 for patients with high deductibles.

The authors noted that “no significant differences were found regarding credit scores or amount of nonmedical debt in collections.” In addition, financial distress has been associated with “worse long-term physical and mental health after injury.”

The study linked Blue Cross Blue Shield of Michigan preferred provider organization insurance claims from 2019 through 2021 (excluding July-December 2020) to January 2021 Experian consumer credit reports.

3. Role of stimulants in drug overdoses eclipsed by ‘national focus on the opioid crisis’

“Deaths involving stimulants are on the rise,” according to a new infographic by the NICHM Foundation, which also provides strategies to reduce drug overdose deaths.

The authors noted that death from stimulants, including prescription stimulants, such as those used to treat ADHD and depression, as well as cocaine, methamphetamine and ecstasy, have been “overshadowed by the national focus on the opioid crisis.”

The infographic shows the following:

• Between 2013 and 2020, deaths involving cocaine nearly quadrupled (from 4,939 to 19,429) and deaths involving psychostimulants (primarily methamphetamine) more than sextupled (from 3,616 to 23,776).
• In 2020, stimulants were involved in 40,568 overdose deaths. However, the authors noted that “a single death may involve multiple substances, including not only stimulants but also opioids and other drugs.
• Cocaine and psychostimulants (meth) are each involved in more deaths than either prescription opioids or heroin.

“Strategies to reduce drug overdose deaths include promoting evidence-based solutions in prevention, harm reduction, treatment and recovery efforts,” wrote the authors. “Additionally, efforts are needed to improve data collection. This includes the collection of timely and local data, making real-time data available for analysis, and using gathered information to inform community-tailored interventions.”

HFMA bonus content

Read “Breaking down Medicare’s controversial physician payment update for 2023,” written by Nick Hut, HFMA senior editor.

Listen to the Voices in Healthcare Finance podcast episode “Healthcare disruptors like Amazon get good patient reviews, but questions about quality abound,” hosted by HFMA’s Erika Grotto.