Nation's Leading Patient Advocacy Group Unveils New Patient Data Analysis Report; Finds Increase in Case Complexity, Medicare Denials, Underinsured

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Apr 28, 2010, 12:00 ET

New trend findings based on successful resolution of more than 55,000 cases by

national, non-profit Patient Advocate Foundation in 2009

NEWPORT NEWS, Va., April 28 /PRNewswire-USNewswire/ -- Patient Advocate Foundation (PAF) -- a national non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases -- today released their annual Patient Data Analysis Report (PDAR), which documents the scope and complexity of the healthcare finance, access and job retention issues routinely confronted by patients at the national and state-specific level. Regarded as a thorough and reliable information source by policymakers, healthcare providers, stakeholders and other members of the healthcare community, this expert data analysis offers a comprehensive summary of issues, on both a national and state by state level, impacting Americans' access to healthcare. Globally, nearly two-thirds of the 55,000 patients contacting PAF for information and assistance in 2009 reported debt crisis issues due to direct medical expenses, and over 80 percent of those patients were fully insured. Seventy-six percent of the patients contacting PAF in 2009 are cancer patients. The remaining 23 percent have chronic diseases including diabetes, osteoporosis, COPD, HIV, AIDS, chronic kidney disease, hepatitis, et. al.

"PAF publishes the annual PDAR to provide an up-to-date snapshot of healthcare trends in America from the front lines that we hope can serve as a reference for healthcare policymakers and other stakeholders as they work to address the healthcare crisis America continues to face," said Nancy Davenport-Ennis, founder and CEO of PAF. "We have been encouraged by the continued collaborative process in Congress and the promise the historic passage of healthcare reform brings. However, the 2009 PDAR shows that we have reached a point where a growing amount of patients are unable to access or afford the medical care they need – despite having health insurance coverage – and we must not lose sight of the critical need to ensure that, bottom line, all patients can access care."

One striking trend involved Medicare beneficiaries. Despite having Medicare coverage, PDAR data of 2009 PAF patients showed a striking 128 percent growth rate in denials as opposed to previous years. Further, nearly half of the Medicare beneficiaries seeking assistance are under age 65 and Medicare eligible due to disability.

Data released in the new PDAR shows that patients contacting PAF in 2009 were more frequently reporting difficulties with both obtaining and keeping adequate levels of health insurance coverage. The detailed analysis of last year's cases indicates that patient cases are becoming increasingly complex with more than 23 percent of patients reporting two or three health conditions at one time, which requires more PAF staff time and effort to bring to resolution.

"Each year, PAF is able to help more Americans gain access to the healthcare services they need, but we continue to see thousands of patients and family members struggle with medical debt crisis issues and personal bankruptcies, which are driven by the inability to pay for ballooning medical expenses," added Davenport-Ennis. "In 2009, we continued to see a dramatic increase in COBRA issues with benefits and eligibility shrinking due to continued job loss and unemployment, creating significant access issues for patients nationwide."

The PDAR collects and assesses data from each patient case received throughout the year by PAF's professional senior patient navigators. In addition to providing analysis of national healthcare trends, the PDAR highlights PAF's 14-year history in resolving complex health insurance access issues, such as benefit denials and appeals. Originally published in 1997, this data has been increasingly requested by lawmakers, MedPAC, congressional offices, academics and advocacy organizations.

Patient Advocate Foundation is a national non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability. PAF is on the frontlines of the healthcare access battle millions of Americans fight every day. Last year alone, PAF received in excess of 4 million contacts from patients, family members and care professionals requesting access to care information and assistance. Of those contacts, PAF's professional senior patient navigators successfully resolved 55,384 cases for patients that required direct, sustained mediation and arbitration services. Since its inception in 1996, PAF has touched more than 35 million American lives. For more information about Patient Advocate Foundation or to request a copy of the 2009 PDAR, please visit www.patientadvocate.org or call toll free (800) 532-5274.

SOURCE Patient Advocate Foundation