Cases spiked in 2011, says Patient Advocate Foundation

A statistical analysis conducted by non-profit Patient Advocate Foundation (PAF) offers a composite view of patient demographics and health conditions across the United States. On April 24, PAF released its annual Patient Data Analysis Report (PDAR), which covers more than 103,000 patients assisted by PAF in 2011.

PAF helps patients with one-on-one case management services by addressing access issues, insurance obstacles, medical debt crisis and job retention issues. The organization said seeks to “safeguard patients through effective mediation ensuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases.”

In 2011, PAF served 103,112 patients, representing a 24.3 percent increase in patient cases compared to the 2010 calendar year, and an 86.2 percent increase in annual cases resolved since 2009.  Of the patients served by PAF case managers, 69 percent of patients who contacted PAF were cancer patients, with the remaining patients dealing with a wide array of chronic or debilitating conditions including cardiovascular, autoimmune, nervous system and pediatric illness among others.

PAF assisted patients in all 50 states and several territories; however 10.1 percent of all patient calls were from Texas, which took the lead as PAF's top referral state.  2011 is the first time since 2004 that Florida has not had the highest number of patient referrals, with Florida now placed in the number two position, followed by California, Virginia and New York. 

The 2011 data analysis shows numerous shifting trends, including the following:

  • For the first time since 2007, Medicare beneficiaries surpassed the uninsured population as the second most frequently reported insurance coverage type. For 2011, uninsured patients represented the third most prevalent insurance status type.
  • Among commercially insured patients, 26.3 percent of patients were unemployed, frequently as a result of their debilitating medical condition, and 16.9 percent were utilizing their COBRA benefits. Nearly 65 percent of those patients reported earning less than $34,000 annually. 
  • Nearly a quarter of patients served reported two or more health conditions, representing an increase over previous years.
  • 11 percent of uninsured patients reported not being able to access screening for symptoms through a medical provider, while between one and two percent of patients with insurance coverage reported the same issue. In 2011, more uninsured patients reported significant difficulty in getting services, which represents a dramatic shift from 2010 data, in which the majority of uninsured patients reported difficulty paying for healthcare services that were provided.
  • Case managers saw an increasing population of PAF patients receiving disability benefits in 2011.
  • PAF saw greater patient diversity in 2011 in terms of age, ethnicity, insurance status, employment status, household income and diagnosis and health conditions reported. 

The cost of treatment and the financial burden placed on patients (and their families) facing treatment is one of the most common concerns reported to PAF, with 31.4 percent of cases citing this scenario. Issues surrounding debt crisis often overlap and encompass many other areas, PAF reported. Those issues may include: increasing insurance premiums with less coverage, the inability to afford increased co-insurance or co-payment obligations, the inability to afford COBRA premiums and the loss of employer-sponsored benefits.

Originally published in 1997, PDAR data has been increasingly requested by lawmakers, MedPAC, congressional offices, academics and advocacy organizations as a quality assessment across many different dimensions, including age, ethnicity, employment status and clinical conditions, PAF noted.

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