The Growing "Out of Pocket" Healthcare Market (Spending on Surgeries, Pharmaceuticals and Other Healthcare Services)

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