Pulse Check: Capturing Provider Perspectives on Medical Debt in the Patient Encounter 

Undue Medical Debt recently launched a 1-year project thanks to a generous $250,000 grant from the Robert Wood Johnson Foundation (RWJF). The project, Pulse Check: Capturing Provider Perspectives on Medical Debt in the Patient Encounter, explores how clinicians currently manage patient conversations about carrying or incurring medical debt and how they view their roles in helping patients navigate financial hurdles to care.  

Data consistently shows that patients increasingly make care decisions based on financial considerations; almost half of respondents to a Commonwealth Fund survey skipped or delayed care on account of costs. Clinicians may not only be unaware that fear of medical bills is a factor in a patient’s health care decision-making, but also may feel ill-equipped to address patients’ financial concerns. Further, clinicians are often outside of the conversations on the systemic causes of medical debt for their patient population. Additionally, they are often a burdened and exhausted workforce, managing many demands in addition to providing patient care. We will attempt to create a space for feedback and strategy building that accommodates these pressures.  

Physicians are trusted messengers, however, that have influence across multiple settings. Therefore, by stewarding physicians as champions who can elevate the issue of medical debt and call for policy change to mitigate its harms, this project seeks to re-orient the national narrative about a broken health system by centering the problem of medical debt through the lens of those providing care.  

Undue Medical Debt is working with messaging firm PerryUndem to facilitate virtual focus groups to get in-depth data and insights on the physician’s experience with patient medical debt. In order to engage physicians across a range of different geographies, specialties, institutions, and demographics, Undue Medical Debt is partnering with Communities Joined in Action (CJA), a private, national non-profit membership organization of nearly 150 community health collaboratives. Together, we will: 

1. Document barriers providers face with respect to patient medical debt and identify what approaches they are currently using to help their patients.  

2. Synthesize provider concerns about medical debt and identify opportunities they might leverage to affect institutional or public policy change.  

3. Build tools to support providers as leaders and advocates, elevating the issue of medical debt and calling for policy change to mitigate its harms.  

4. Begin to lay the groundwork for longer-term policy change by elevating voices of providers in support of affordable, quality coverage and access and social/economic supports for financially burdened individuals with a particular focus on policies that address the harms of medical debt. 

This work contributes to a broader conversation on the cost of care and is both timely for policy interventions and prescient of the issues we know impact constituents of Undue Medical Debt and most every consumer of health care whether they’re uninsured (because of unaffordable premiums or time-consuming/complex navigation) or underinsured with limited in-network availability, high deductibles and/or high out-of-pocket costs. Stay tuned for updates on our progress over the coming months!