Today the 澳博官方网站app 研究所 released a first-ever study showing American families are deferring healthcare treatments until tax refunds arrive in bank accounts-underscoring the role of liquidity in spurring access to healthcare. 的 report finds the overall level of healthcare spending is 60 percent higher in the week after receiving a tax refund payment than in a typical week over the 100 days before. 在收到退税后的一周内, 借记卡支付的医疗费用增加了83%, while there was no offsetting change to credit card spending—suggesting the cash infusion provided by the tax refund was a major determining factor driving changes in healthcare spending behavior. 此外, 退税引发的额外医疗支出中，62%是由医疗服务提供者亲自支付的. 这意味着现金流动态不仅影响消费者支付医疗保健的时间，还影响他们获得医疗保健的时间.

的 change in healthcare spending triggered by the arrival of a tax refund was even more pronounced among families with a low cash buffer. Account holders in the highest checking account balance quintile (more than $3500) only increased healthcare spending 11 percent after the arrival of a tax refund, while account holders in the lowest quintile (less than $536) increased healthcare spending 220 percent after a tax refund arrived—a spending reaction nearly 20 times larger in magnitude.

“我们已经知道，许多家庭没有足够的现金缓冲来支付重大医疗紧急情况的费用. Now we also see that a significant number of Americans put off going to the doctor and other routine health services until they actually have cash in their account, 即使他们知道它即将到来,” Diana Farrell，澳博官方网站app研究所总裁兼首席执行官.“除了是一个主要的个人理财问题, 医疗保健和现金流之间的这种联系可能对公共卫生产生重大影响. 我们需要更好地理解财务健康和身体健康之间的联系, 包括评估在等待现金到位的同时推迟治疗的后果."

这份报告, 递延医疗:退税如何促进医疗支出, 显示家庭一直推迟医疗保健支付，直到他们收到退税付款, 即使一旦他们提交了申请，他们也知道要期待多少钱. 该报告利用了1个国家的日常医疗保健支出数据.200万支票账户持有人 澳博官方网站app研究所医疗保健自付支出小组(JPMCI HOSP) 从2014年到2016年，谁每年都获得了退税. 当退税款项到来时，许多类别的支出似乎都增加了, 但医疗保健是特殊的，因为推迟它可能会产生后果.

该报告的一些关键要点包括:

• 现金流动态, 特别是退税, 是自费医疗支出的重要驱动因素吗. 即使消费者几乎肯定地知道大笔现金注入的规模和来源, 他们仍然会等到现金注入到来后再消费.
  • 的 overall level of healthcare spending is 60 percent higher in the week after receiving a tax refund payment than in a typical week over the 100 days before. 对现金注入的反应在大约75天后逐渐减弱. 在收到退税后的一周内, 借记卡支付的医疗费用增加了83%, 电子支付增长了56%. 信用卡消费没有相应的变化.

• 现金流动态驱动消费者何时获得医疗保健，而不仅仅是在他们支付医疗保健费用时. 这对于牙齿治疗来说尤其如此.
  • Consumers who spent more when they receive their tax refund spent those funds disproportionately on in-person healthcare services that were likely deferred from the period before the refund arrived.
  • 看牙医和看医生占了延迟治疗的一半以上，而这些延迟治疗本应更早得到, 如果退税款项来得早.
  • 牙医获得了32%的退款引发的额外支出，这是一个不成比例的份额. 相比之下, 在退税支付前的期间内, 在支付给服务提供商的个人费用中，只有27%的人去了牙医那里.

• 现金流动态 have an outsized impact on healthcare decisions for consumers with low liquidity or no limited access to credit.
  • 的 cash infusion from a tax refund triggered a significantly sharper increase in healthcare spending among account holders who had lower checking account balances or who did not have a credit card prior to receiving their tax refund. We also observe that consumers who had more liquidity or access to credit were less likely to delay their healthcare spending until their tax refund arrived.

的 澳博官方网站app研究所医疗保健自付支出小组(JPMCI HOSP)于2017年9月首次建成. 资产遵循2的样本.从2013年1月到2016年12月，共有300万名年龄在18岁至64岁之间的大通常客. 该研究所将自费医疗保健支出定义为向医疗保健提供者和药店支付的任何观察到的付款, 包括共同支付, 共同保险, 免赔额, 以及其他医疗服务点, 牙科, 或者毒品消费.

主要结论: 递延医疗:退税如何促进医疗支出

• Finding 1: Consumers immediately increased their out-of-pocket healthcare spending by 60 percent in the week after receiving a tax refund payment. 支出 remained elevated for about 75 days; during this entire period of elevated spending, 与退税前的同期相比，消费者在医疗保健上的支出总额增加了20%.
  • 这一增长是由两个因素驱动的——每天的医疗费用增加, 每天有更多的账户持有人支付医疗费用.
  • 典型的消费者花费11美元.在消费增加的时期，平均每天增加1%, 与退款前相比. This increase in the average payment was driven in large part by an increase in the largest payment amounts (account holders spending $150 or more in a single day). 的 cash infusion generated by a tax refund payment triggered additional spending on large healthcare ticket items that consumers could have least afforded out of their pre-refund cash flow.
  • 一般来说，每天的消费人数增加了约7人.5%.

• 发现2:在收到退税后的一周内, 借记卡支付的医疗费用增加了83%, 电子支付增长了56%. 信用卡消费没有相应的变化. This suggests that the liquidity provided by the tax refund enabled customers to pay for unmet healthcare needs or unpaid healthcare bills.
  • 此外, 未满足的医疗保健需求似乎更大, 在总, than other spending needs after the tax refund: non-health spending on debit cards increased by 54 percent in the week after the tax refund (compared to 83 percent for healthcare spending).

• Finding 3: In-person payments to healthcare service providers represented 62 percent of tax refund-triggered additional healthcare spending. 这表明现金注入的时机会影响消费者获得医疗保健的时间, 不仅仅是在他们支付医疗费用的时候.
  • Payments in person at service providers were 54 percent higher during the seven days after account holders received their first tax refund payment than a typical week prior to the refund.
  • 对服务提供商的远程支付增加了79%, 但与面对面支付相比，这种支付的基数更小，持续时间也更短. 支付给可储存医疗用品供应商的费用仅增长了22%.

• Finding 4: 的 tax refund caused consumers to make visits to dentist and doctor offices and pay outstanding hospital bills they had likely deferred from the period prior to the refund payment.
  • 牙医们在由退税引发的额外支出中获得了不成比例的份额——32%. 相比之下, 在退税支付前的期间内 在支付给服务提供商的个人费用中，只有27%的人去了牙医那里.
  • 由退款引发的额外支出不太可能流向医生或医院, 分别为23%和6%, 而在退款前，这一比例分别为27%和7%.
  • 其余39%的人选择了其他医疗保健服务, 包括护理服务提供者, 救护车服务提供者, 医学实验室, 眼镜商, 验光师, 和按摩师. 在支付给服务提供商的由退款触发的远程支付中，医院收到的比例过高(31%), 而在退款前，这一比例为28%).

• Finding 5: 现金流动态 had less effect on the out-of-pocket healthcare spending patterns of consumers who had higher balances in their checking accounts or who had a credit card before the payment arrived.
  • 平均每日支票账户余额低于536美元的账户持有人中(最低的五分之一), weekday healthcare spending was 220 percent higher in the week after receiving the first tax refund payment compared with a typical week prior to the refund payment.
  • 适用于日均结余超过3美元的账户持有人,577(最高平衡五分位数), 在现金注入的情况下，医疗支出只增加了11%.
  • Weekday healthcare spending increased more sharply among those who did not have a credit card (104 percent) than among those who did (48 percent).

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