Why are so many Americans denied medical care even when they have insurance? In a recent interview with CBS News, Miranda Yaver (University of Pittsburgh) explained that while nearly half of all appeals are successful, only a tiny fraction of insurance denials are ever contested by patients.
Drawing on her recent Journal of Health Politics, Policy, and Law article, Yaver - a former recipient of the CAPE small grant program – argues that insurance companies contain costs by liberally denying initial claims, knowing that the appeals process creates an administrative burden that exhausts most policyholders.
This strategy, which she calls “rationing by inconvenience”, has particularly deleterious effect on poor and marginalized communities who are less likely to appeal, thereby deepening healthcare inequities.
Watch the full CBS News segment, and be sure to check out her article, "Rationing by Inconvenience: How Insurance Denials Induce Administrative Burdens."
