Table of Contents
CHAPTER ONE: EXECUTIVE SUMMARY
- Out of Pocket Expenditures : Current Market
- The U.S. Healthcare Market
- The Need for Alternatives
- High Cost of Care
- Inconsistent Quality of Care
- Inaccessible Care
- Vulnerable Populations
- Consumers Who Pay Out of Pocket
- Medicaid Recipients
- Disabled Persons
- Senior Citizens
- The Mentally Ill
- Obese Persons
- Persons with Chronic Medical Conditions
- Health Care Reform
- Types Of Out Of Pocket Payments
- Insurance Co-Payments
- Direct Payments
- Premiums and Plan Fees
- Payment Methods
- Cash or Check
- Credit Cards
- Flexible Spending Accounts
- Loans and Lines of Credit
- Health Savings Accounts
- Health Care Financing
- Non-Elective Procedures and Prescription Drugs
- Types of Expenses Financed
- Elective Procedures
- Non-Elective Procedures and Prescription Drugs
- Trends In Out Of Pocket Spending
- Health Care Inflation
- Managed Care Cost Shifting
- Retail Clinics
- Disease Management Programs
- Medicare Prescription Drug Benefit
- Generic Drugs
- Rx-to-OTC Switches
- Medical Tourism
- Health Care Advisers
- Medical Procedure Financing
- Types of Procedures Financed
- Elective Procedures
- Non-Elective Procedures
- Financing Products
- Scope and Methodology
CHAPTER TWO: HEALTH CARE PAYMENTS AND COVERAGE
- Overview
- Public Health Care
- Private Health Care
- State-Licensed Health Insuring Organizations
- Commercial Health Insurers
- Blue Cross and Blue Shield Plans
- Health Maintenance Organizations
- Self-Funded Employee Health Benefit Plans
- Participation
- Cost Issues
- The Uninsured And Underinsured
- The Uninsured
- The Underinsured
- Regulation
- Health Care Reform
- Universal Federal Health Care Coverage
- State Health Care Coverage
- Current State Health Care Initiatives
- Federal Support of State Health Care Reform
CHAPTER THREE: OUT-OF-POCKET EXPENDITURES: THE CURRENT MARKET
- Overall Out-Of-Pocket Spending
- Payments Types
- Insurance Co-Payments
- Direct Payments
- Premiums and Plan Fees
- Payment Methods
- Cash or Check
- Credit Cards
- Flexible Spending Accounts
- Loans and Lines of Credit
- Health Savings Accounts
- Health Care Financing
- Amount Financed
- Elective Procedures
- Non-Elective Procedures and Prescription Drugs
- Consumers Who Pay Out Of Pocket
- Medicaid Recipients
- The Disabled
- Senior Citizens
- The Mentally Ill
- Obese Persons
- Persons with Chronic Conditions
CHAPTER FOUR: OUT-OF-POCKET EXPENDITURES: THE MARKET IN 2007-2011
- Trends
- Out-of-Pocket Expenditure Growth Drivers
- Health Care Inflation
- Managed Care Cost-Shifting
- Retail Clinics
- Services
- Pricing
- Consumer Response
- Expansion
- Out-of-Pocket Expenditure Growth Constraints
- Disease Management Programs
- Medicare Prescription Drug Benefit
- Generic Drugs
- Private-Label OTC Medications
- Rx-to-OTC Switches
- Medical Tourism
- Health Care Advisers
- Forecasts
- Payment Type
- Payment Methods
- Amount Financed
- Elective Procedures
- Non-Elective Procedures
- Consumers Who Pay Out of Pocket
CHAPTER FIVE: SOURCES OF MEDICAL PROCEDURE FINANCING, 2006
- Types Of Procedures Financed
- Elective Procedures
- Chiropractic Services
- Cosmetic Surgery
- Cosmetic Dentistry
- Elective Eye Procedures
- PRK Procedures
- LASIK Procedures
- LASEK
- Forecast
- Hair Restoration
- Fertility Treatments
- Weight Loss Surgery
- Non-Elective Procedures
- Financing Programs
- Costs to Consumers
- Costs to Providers
- Usage and Acceptance
- Key Players
- Elective Procedures
- Non-Elective Procedures
CHAPTER SIX: SOURCES OF MEDICAL PROCEDURE FINANCING, 2007-2011
- Trends
- Consumers
- Consumer Debt
- Payday Loans
- Weak Housing Market
- Widening Wage Gap
- Financial Awareness
- Security Concerns
- Financial Institutions
- Increasing Share of Wallet
- New Credit Card Products
- New Credit Card Customer Segments
- Forecasts
CHAPTER SEVEN: COMPANY PROFILES
- APFUSA
- Aurora Quick Care
- Capital One Healthcare Finance
- Care Credit
- Checkups
- Credit Medical
- CSI Financial Services
- Health Ready
- Medchoice Financial
- Meddirect
- Medprova
- Minuteclinic
- PFS
- Rediclinic
- Reliance Medical Finance
- Solantic
- Springstone Patient Financing
- Take Care Health Systems
- Target Clinical Medical Associates
TABLE OF EXHIBITS
CHAPTER ONE: EXECUTIVE SUMMARY
- Figure 1-1: The U.S. Out of Pocket Healthcare Market, 2006-2011, Elective
and Non-Elective Spending (in billions)
- Figure 1-2: U.S. Consumer Out-of-Pocket Health Care Expenditures by
Service Required, 2006
- Figure 1-3: U.S. Healthcare Consumers Highly Likely to Pay Out of Pocket,
2006-2011 (millions)
- Figure 1-4: U.S. Healthcare Consumers Likely to Pay Out of Pocket, by
Contributing Factor 2006 (Persons with Chronic Conditions, Medicaid, Disabled,
Senior Citizens, Mentally Ill, Obese)
- Figure 1-5: Average Share Paid Out of Pocket by U.S. Consumers, by
Percentile of Total Health Care Spending and Type of Service, 2003
CHAPTER TWO: HEALTH CARE PAYMENTS AND COVERAGE
- Figure 2-1: National Health Expenditures (NHE) and NHE as a Percentage of
GDP, 1980-2011
- Figure 2-2: Premium Increases vs. Increases in Workers' Earnings and
Inflation, 1989-2005
- Table 2-1: Selected U.S. Federal and State Health Care Oversight
Bodies,2007
- Table 2-2: U.S. Health Care Coverage by State,2007
CHAPTER THREE: OUT-OF-POCKET EXPENDITURES: THE CURRENT MARKET
- Figure 3-4: Average Share Paid Out-of-Pocket by U.S. Consumers, by
Percentile of Total Health Care Expenses, 2003
- Figure 3-5: Average Amount Paid Out-of-Pocket by U.S. Consumers, by
Percentile of Total Health Care Expenses, 2003
- Figure 3-1: U.S. Consumer Out-of-Pocket Health Care Expenditures: Direct
Payments, Co-Pays and Premiums, 2006
- Figure 3-2: U.S. Consumer Out-of-Pocket Health Care Expenditures by
Payment Type, 2006
- Table 3-1: Credit Card Debt of Consumers with Medical Debt by Health
Insurance Status,2007
- Table 3-2: Credit Card Debt of Consumers with Medical Debt by Demographic
Group, 2007
- Figure 3-3: Methods of Payment for Elective Procedures, 2006
- Figure 3-4: U.S. Consumer Out-of-Pocket Spending for Elective Procedures,
Amount Financed vs. Paid with Cash or Check, 2003
- Figure 3-7: Average Share of U.S. Health Care Expenses Paid Out of Pocket,
by Type of Service, 2003
- Figure 3-8: Average Share Paid Out of Pocket by U.S. Consumers, by
Percentile of Total Health Care Spending and Type of Service, 2003
- Figure 3-9: Distribution of Out-of-Pocket Spending on Non-Elective
Procedures for the Average Person, 2003 71
- Figure 3-10: Distribution of Out-of-Pocket Spending for the Average
Person, by Spending Level and Type of Service, 2003
- Figure 3-11: Drug Cost Coverage by Payor Type (Public, Private, Cash),
1965, 1986, 2000, 2004
- Figure 3-12: Change in Out-of-Pocket Health Care Expenses for Medicaid
Recipients, 1997 to 2002
- Figure 3-13: Out-of-Pocket Health Care Expenses for Disabled and
Non-Disabled Medicaid Recipients, 1997 vs. 2002
- Table 3-3: Obesity in the U.S., 1980-2011
- Figure 3-14: Adults Under Age 65 with Chronic Conditions by Type of
Insurance, 2003
CHAPTER FOUR: OUT-OF-POCKET EXPENDITURES: FORECASTED MARKET TO 2011
- Figure 4-1: Extent to Which Consumers Believe Cost-Shifting Will Result in
Beneficial Outcomes, 2003
- Figure 4-2: Growth of U.S. Retail Clinics, 2001-2011
- Table 4-1: Selected Rx-to-OTC Switches in the United States, 1982-2007
- Table 4-2: Rx-to-OTC Switch Candidates in the U.S., 2007-2012
- Table 4-3: Cost Savings From Medical Tourism for Various Procedures, 2007
- Table 4-4: U.S. Consumer Out-of-Pocket Expenditures per Worker, 2001-2011
- Table 4-5: U.S. Consumer Out-of-Pocket Expenditures by Payment Type,
2001-2011
- Figure 4-3: Distribution of U.S. Consumer Out-of-Pocket Spending by
Payment Type, 2001, 2006, 2011
- Table 4-6: U.S. Consumer Out-of-Pocket Expenditures by Payment Method,
2001-2011 Figure 4-4: Distribution of U.S. Consumer Out-of-Pocket Spending by
Payment Method, 2001, 2006, 2011
- Table 4-7: Amount of U.S. Consumer Out-of-Pocket Expenditures for Elective
Procedures , 2001-2011 (in billion $)
- Figure 4-5: Share of U.S. Consumer Out-of-Pocket Spending for Elective
Procedures Paid for Through Financing, 2006-2011
- Table 4-8: Amount of U.S. Consumer Out-of-Pocket Expenditures for
Non-Elective Procedures , 2001-2011 (in billion $)
- Figure 4-6: Distribution of Out-of-Pocket Spending on Non-Elective
Procedures for the Average Person, 2006 vs. 2011
- Figure 4-7: Share of U.S. Consumer Out-of-Pocket Spending for Non-Elective
Procedures Paid for Through Financing, 2006-2011
- Table 4-9: Size of High-Risk Groups for High Out-of-Pocket Health Care
Expenditures, 2001-2011 (in millions)
CHAPTER FIVE: SOURCES OF MEDICAL PROCEDURE FINANCING, 2006
- Figure 5-1: Distribution of Medical Procedure Financing Market, 2006
- Table 5-1: Cosmetic Surgical Procedures Offered in the U.S., 2007
- Table 5-2: Firtility Treatments in the U.S., 2007
- Table 5-3: Leading Weight Reduction Surgeries Offered in the U.S., 2007
- Table 5-4: Comparison of Selected Medical Financing Program Costs to
Consumers, 2006
- Table 5-5: Selected Elective Procedures Covered by Leading Medical
Financing Companies, 2007
- Figure 5-2: Leading Players' Share of U.S. Elective Procedure Financing
Market, 2006
- Table 5-6: Selected Non-Elective Procedures Covered by Leading Medical
Financing Companies, 2007
- Figure 5-3: Leading Players' Share of U.S. Elective Procedure Financing
Market, 2006
CHAPTER SIX: SOURCES OF MEDICAL PROCEDURE FINANCING, 2007-2011
- Table 6-1: Consumer Out-of-Pocket Expenditures for Elective Procedures
Paid Through Patient Financing Programs, 2001-2011 (in billion $)
- Table 6-2: Consumer Out-of-Pocket Expenditures for Non-Elective Procedures
Paid Through Patient Financing Programs, 2001-2011 (in billion $)
- Figure 6-1: Consumer Out-of-Pocket Expenditures for Elective and
Non-Elective Procedures Paid Through Patient Financing Programs, 2001-2011 (in
billion $)
- Figure 6-2: Proportion of Consumer Out-of-Pocket Spending for Elective
Procedures Paid Through Patient Financing Programs, 2006-2011
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