FAIR Health to Release Report on National Surveys of Older Adults and Family Caregivers

January 20, 2022

On February 14, FAIR Health will release a report on two national surveys of older adults (those aged 65 and older) and family caregivers/care partners. Conducted as part of an initiative generously funded by The John A. Hartford Foundation, the surveys revealed critical insights into the needs of older adults and family caregivers/care partners concerning healthcare navigation and decision making.

In 2021, The John A. Hartford Foundation awarded FAIR Health funding for “A National Initiative to Advance Cost Information in Shared Decision Making for Serious Health Conditions.” The 18-month initiative will expand FAIR Health’s existing shared decision-making tools, which are currently focused on palliative care scenarios, through the creation of four new decision aids related to the care of older adults. The decision aids will combine clinical and cost information focused on treatment options for early-stage breast cancer, fast-growing prostate cancer, spinal stenosis and hip osteoarthritis. As part of the grant, FAIR Health also will launch new “total treatment cost” scenarios highlighting the range of costs associated with three conditions particularly relevant to an older population: Alzheimer’s disease/dementia, heart failure and major depression. These free tools will be accompanied by educational materials and resources that support both older adults and family caregivers in navigating the healthcare system.

For this initiative, FAIR Health conducted two separate surveys: one with older adults aged 65 and older and one with caregivers/care partners aged 18 and older. The surveys, conducted in collaboration with ENGINE Insights, were fielded in November 2021 and reached 1,005 older patients and 507 caregivers/care partners. Each survey asked respondents about the importance of healthcare costs to decision making, attitudes toward shared decision making, barriers to informed decision making and healthcare navigation, navigation of the healthcare system and needs for resources and tools. Following are a few of the findings to be discussed in detail in the report:

• One in four older adults (aged 65 and older) never know the costs of healthcare services before getting a bill. Although 32 percent of older adults reported that they “sometimes” know the costs of healthcare services before receiving their bill, 25 percent of older adults reported that they “never” know costs of healthcare services before receiving their bills, while 21 percent reported that knowing their healthcare costs in advance depended on whether the care was given by healthcare providers in their health plan network or not in their network.
• Though most older adults consider healthcare costs to be an important factor when making healthcare decisions, more than a third have difficulty getting such cost information. Thirty-seven percent of older adults felt that healthcare costs are an “important” factor when making healthcare decisions, and 22 percent felt that it was the “most important” factor when making healthcare decisions. Sixteen percent of older adults reported that healthcare costs were “a thought” when making a healthcare decision, while 24 percent reported that they do not think about out-of-pocket cost when making a healthcare decision. However, 35 percent reported that they found getting information about their healthcare costs to be “somewhat hard” or “very hard.”
• While most caregivers/care partners consider costs to be an important factor in making decisions about the person for whom they provide care (their care receiver), most do not discuss costs with healthcare providers. Sixty-four percent of caregiver respondents felt that healthcare costs should be “important” or “very important” to their care receivers’ healthcare providers and/or teams. However, only 42 percent reported that they discussed those costs with their care receivers’ healthcare providers and/or teams.

The full survey report will be released on fairhealth.org.