Report: 26% of Older Adults Put Off Care Due to Cost

Home Care Magazine | Tuesday, February 15, 2022

NEW YORK (February 15, 2022)—As part of an initiative funded by The John A. Hartford Foundation, FAIR Health conducted a nationwide study comprising two surveys geared toward older patients (adults 65 and older) and family caregivers/care partners. The surveys revealed critical insights into the needs of older adults and their caregivers/care partners concerning health care navigation and decision making. The survey findings have been published in FAIR Health's new white paper, “Healthcare Navigation and Decision Making: Perspectives of Adults Aged 65 and Older and Family Caregivers.”

Key Findings

FAIR Health conducted two separate surveys: one with older adults aged 65 and older and one with family 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 health care costs to decision making, attitudes toward shared decision making, barriers to informed decision making and health care navigation, and navigation of the health care system and needs for resources and tools. Analysis of the results revealed the following:

• One in four older adults (aged 65 and older) never know the costs of health care services before getting a bill. Although 32% of older adults reported that they "sometimes" know the costs of health care services before receiving their bill, 25% of older adults reported that they "never" know costs of health care services before receiving their bills, while 21% reported that knowing their health care costs in advance depended on whether the care was given by health care providers in their health plan networks or those not in their health plan's network.
  
  
• A significant proportion of older adults consider health care costs to be an important factor when making health care decisions; more than a third have difficulty getting such cost information. Thirty-seven% of older adults felt that health care costs are an "important" factor when making health care decisions, while 22% felt that it was the "most important" factor when making health care decisions. Sixteen% of older adults reported that health care costs were "a thought" when making a health care decision, while 24% reported that they do not think about out-of-pocket cost when making a health care decision. However, 35% reported that they found getting information about their health care costs to be "somewhat hard" or "very hard."
  
  
• While a significant proportion of family 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 health care providers. Sixty-four% of caregiver respondents felt that health care costs should be "important" (34%) or "most important" (30%) to their care receivers' health care providers and/or teams. Twenty-four percent of caregiver respondents reported that they did not want the health care provider to think about out-of-pocket costs in decisions about their care receiver's care. However, only 42% reported that they discussed those costs with their care receivers' health care providers and/or teams. Among the subset of caregiver respondents who reported that they do not discuss costs with their care receivers' health care providers and/or teams, 64% would not like to engage in such discussions.
  
  
• Despite a strong interest in having shared decision-making discussions, just under a third of older patients do not have such conversations with their health care providers and/or health care teams. Forty-five percent of older adults are "interested" or "very interested" in having shared decision-making discussions with their health care providers and/or health care teams. Moreover, 41% reported that they "always" or "often" take part in such discussions with health care providers. However, 29% reported that they have "never" engaged in shared decision making with their health care providers. . . 

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Delay Ahead for Pfizer's COVID-19 Vaccine for Kids Under 5

By Lauran Neergaard and Matthew Perrone, Associated Press | Feb. 11, 2022 

WASHINGTON — U.S. regulators on Friday put the brakes on their push to speed Pfizer's COVID-19 to children under 5, creating major uncertainty about how soon the shots could become available.

The Food and Drug Administration had urged Pfizer and its partner BioNTech to apply for authorization of extra-low doses of its vaccine for the youngest children before studies were even finished — citing the toll the omicron variant has taken on children.

Next week, FDA advisers were supposed to publicly debate if youngsters should start getting two shots before it's clear if they'd actually need a third.

But Friday, the FDA reversed course and said it had become clear it needed to wait for data on how well that third shot works for this age group. Pfizer said in a statement that it expected the data by early April.

FDA's vaccine chief Dr. Peter Marks said he hoped parents would understand that the decision to delay was part of the agency's careful review and high scientific standards.

"We take our responsibility for reviewing these vaccines very seriously because we're parents as well," Marks told reporters during a teleconference.

Pfizer's early data showed two of the extra-low doses were safe for kids under 5 and strong enough to give good protection to babies as young as 6 months. But once tots reached the preschool age — the 2- to 4-year-olds — two shots didn't rev up enough immunity.

And a study of a third dose isn't finished yet — meaning the FDA was considering whether to authorize two shots for now with potentially a third cleared later, something highly unusual.

Friday, the FDA didn't say exactly what new data Pfizer was providing except that it involved the critical issue of a third dose.

"We believe additional information regarding evaluation of a third dose should be considered as part of our decision-making," the agency said in a statement.

The nation's 18 million children under 5 are the only age group not yet eligible for vaccination.