Out of Pocket Healthcare Spending 2011

Date: April 22, 2011
Pages: 85
US$ 1,995.00
Publisher: Kalorama Information
Report type: Strategic Report
Delivery: E-mail Delivery (PDF)

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Out of Pocket Healthcare Spending 2011
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The costs of health care products and services continue to rise briskly, significantly outpacing currently low inflation rates. According to the U.S. Department of Labor, the average household's spending on health care after inflation has been rising by about 1.4% each year. Retirees have been particularly hard hit, with inflation-adjusted out-of-pocket costs rising by more than 2% each year as a result of increased spending on prescription drugs.

While insurance is the most common form of payment for healthcare services, increasingly customers are paying for their own expenses. Pharmaceutical, device and diagnostic companies, should recognize that a part of their revenues are originating directly or indirectly from out of pocket expenditures. Unique financial services have been created to facilitate non-insurance-paid health care services, and more are expected to be created in the near term.

This report, Out of Pocket Healthcare 2011 focuses on those costs of health care which are not paid for by government or private insurance. Once a small percentage of costs of the health care system, the percentage borne by the consumer is increasing steadily. Included in the report is:
  • Estimates of the Current 'Out of Pocket' Healthcare Spending Market and Forecasts to 2015.
  • Breakdown of Spending by Type (Elective, Hospital, Emergency Room, Dental, Vision Outpatient, Prescription Drugs, Office Based Visit, Other)
  • Health Care Reform and Its Impact on Out of Pocket Spending
  • Statistics For the Types of Consumers Most Likely to Pay Out of Pocket
  • Drivers of the Out of Pocket Trend and Potential Limiters
  • Overview of the U.S. Healthcare System, Insured and Uninsured Population.
  • The Types of Services and Products Purchased with Out of Pocket dollars
  • Overview of the growing Healthcare Finance market and a look at key competitors.
The economic recession of December 2007 to October 2009 represented a major downturn that led to broad-based cost-cutting, rising unemployment and reduced disposable income. The impact of the pullback - which some experts compared to the Great Depression of 1929 to 1934 - cannot be overstated. Kalorama Information looks at what change has resulted in out of pocket expenditure for healthcare as a result of the recession and weak recovery.

As part of Kalorama Information's trusted process, secondary research from government, medical and industry sources was utilized along with interviews with industry experts in the healthcare finance industry.

Health Care Reform

Impact of the Economy

Out of Pocket Cost Drivers

Healthcare Inflation

Cost Shifting

Retail Clinics

Out of Pocket Cost Limiters

Disease Management Programs

Part D


OTC Products

Where Out of Pocket Dollars are Spent


Types of Expenditures

Insurance Co-Payments

Direct Payments

Premiums and Plan Fees

Cash or Check

Credit Cards

Loans and Lines of Credit

Flexible Spending Accounts

Health Savings Accounts

Medical Financing

Amount Financed

Non-Elective Procedures and Prescription Drugs

Distribution of Out-of-Pocket Spending on Non-Elective Procedures (Hospital, Emergency Room, Dental, Vision Outpatient, Prescription Drugs, Office Based Visit, Other)

Consumers Who Pay Out of Pocket

The Uninsured and Underinsured

Medicaid Recipients

The Disabled

Senior Citizens

The Mentally Ill

The Obese

Persons with Chronic Conditions

Healthcare Finance Competitors

Reliance Medical Finance


Med Direct

MedChoice Financial

E-Financing Solutions

CSI Financial Services

Credit Medical

Care Credit

Capitol One Healthcare Finance


Out-of-pocket Expenditure Growth Drivers

Healthcare Inflation

Managed Care Cost Shifting

Retail Clinics

Out-of-Pocket Expenditure Growth Constraints

Disease Management Programs

Part D

Generic Drugs

Rx-to-OTC Switches


Expenditures by Type (Credit Card, Cash, Loans, Healthcare Financing Programs,HSA)

Payment Methods

Amount Financed

Consumers Who Pay Out-of-Pocket (Uninsured and Underinsured, Medicaid, Disabled, Senior Citizens, Mentally Ill, Obese, Persons With Chronic Conditions.)

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