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20% of Insured Americans Avoid Seeing Doctor Due to Fear of Cost

Author: SCIO Health Analytics : Contact:

Published: 2015-01-24


One in Five insured Americans avoid seeing a doctor due to fear of cost - results suggest significant implications for those with chronic conditions.

Main Digest

A recent online survey conducted by Harris Poll on behalf of SCIO Health Analytics® revealed that approximately two in five insured Americans (38 percent) do not have a good understanding of which healthcare services are covered under their current plan. One in five insured Americans, or approximately 44 million1 people, have avoided visiting a doctor for a general health concern within the past 12 months because of cost concerns.

The online poll surveyed more than 2,000 U.S. adults aged 18-plus about their general sentiments around the Affordable Care Act (ACA) or Obamacare, healthcare costs and their overall understanding of the healthcare system, as well as services covered under their health plan.

Ambiguity and cost fears prevent millions with a chronic condition from visiting their doctor.

Approximately half of U.S. adults (117 million) have at least one chronic condition2, of which 14 percent of (or 16.4 million) have avoided a doctor's visit in the past 12 months because of cost concerns.

Taking the Pulse of Consumers and Healthcare: Harris Poll on Behalf of SCIO Health Analytics
Taking the Pulse of Consumers and Healthcare: Harris Poll on Behalf of SCIO Health Analytics

While chronic conditions such as heart disease, asthma, and diabetes are generally incurable, they can be managed through early detection, improved lifestyle and treatment.

"These findings are particularly relevant at this time as millions of Americans are once again deciding their annual healthcare benefit options through Open Enrollment," said Siva Namasivayam, CEO, SCIO Health Analytics.

"While Americans are spending more time researching health plans, the survey reveals a significant knowledge gap in the specifics of their health care options that may eventually lead to unnecessary risks and costs."

Namasivayam warned that the implications of these findings are even more staggering when you consider treatment costs for Americans with chronic conditions are already around $277 billion annually.3

Avoiding medical treatment for these conditions can lead to an increased risk of complications, emergency room visits, hospitalizations, readmissions, work absenteeism and disability that could potentially drive healthcare costs even higher and cripple an already over-burdened system.

When asked how their healthcare situation has changed since the introduction of the Affordable Care Act:

The survey also found that age and gender play a role in understanding healthcare costs and services.

Among insured adults, 48 percent of those aged 18-34 say they do not have a good understanding of what healthcare services are covered under their plan, compared to 27 percent of those aged 65 and older.

Younger insurance holders, especially men, are also much more likely to be cost-conscious when visiting the doctor. When asked if they avoided visiting the doctor for a general health concern in the past 12 months because of cost concerns, 40 percent of insured men aged 18-34 said yes, whereas 27 percent of insured women in the same age group responded the same (compared to an overall average of 20 percent for all adults age 18+).

While the ACA has encouraged the U.S. healthcare system to become more consumer-focused, this study suggests that health plan managers need to be more aware of the needs of the millions of Americans who are new to health insurance and better communicate with more targeted messages and education around plan coverage and cost.

"It's like buying a car without a manual or taking a test drive. You are left somewhat disoriented in the driver's seat," said Dave Hom, Chief Solutions and Business Development Officer at SCIO Health Analytics.

"Health insurance companies need to adopt customized solutions based on big data to understand and reach these new members. Through the use of segmentation and consumer data such as medical literacy, communication preferences and geographic access to care, companies can find the most effective channels and messages to educate members on coverage, costs, and how to get the care they need."

How do Americans want to receive health plan information? According to the survey:

This survey was conducted online within the United States by Harris Poll on behalf of SCIO Health Analytics from October 28-30, 2014 among 2,026 adults ages 18 and older, of which 1,872 currently have health insurance. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey results and methodology, including weighting variables, please contact, or visit

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