Most Virginians concerned with health care affordability; show bipartisan support for government action to improve.

Richmond, Virginia July 9, 2019 – Today, at a meeting of the Virginia Center for Health Innovation’s board and leadership council, Lynn Quincy, director of Altarum’s Healthcare Value Hub, presented results of the Virginia Consumer Healthcare Experience State Survey. More than half (55%) of the 1,100 adults that responded to the survey indicated they experienced healthcare affordability burdens in the last year and over three-quarters (78%) were worried about affording healthcare in the future. 

The affordability burdens cited ranged from being uninsured due to high premium costs (64%); delaying or forgoing care due to cost (46%); and struggling to pay medical bills (30%).  An overwhelming majority of Virginia respondents (91%) would like access to information showing a “fair” price for specific procedures and 89% support requiring insurers to provide upfront cost estimates to consumers.

The Consumer Healthcare Experience State Survey (CHESS) is designed to elicit respondents’ unbiased views on a wide range of health system issues, including confidence using the health system, financial burden and views on fixes that might be needed.  Nationally, consumer worry about healthcare affordability is well documented, but the results of the Virginia CHESS offer insight on the specific concerns in the commonwealth.  The survey was conducted March 12- April 2, 2019.

Additional key findings include:

  • Healthcare far exceeded other issues as the top issue policymakers should work on in the coming year (63%), with the economy/joblessness (39%) and taxes (37%) as next most important, but cited nearly half as frequently.
  • The top three healthcare priorities respondents want to see action on by the government are addressing high healthcare costs (55%); preserving consumer protections (36%); and getting health insurance to those who cannot afford coverage (35%).
  • High support for government-led change crosses party lines. The majority of respondents – regardless of political affiliation – indicated they supported government action to make it easier to switch insurance (89%); and requiring up-front patient cost estimates from healthcare providers (88%) and insurers (90%).
  • Concerns about healthcare affordability varied by health planning region and income level. Individuals in the Southwest region reported the greatest rate (63%) of healthcare affordability burdens and lowest median income. By contrast, the Northern region reported the fewest affordability burdens (41%) and the highest median income.  
  • The data also show that 1 in 3 respondents with private health insurance received a surprise medical bill. Three-quarters of bill recipients made an effort to resolve the bill before paying it, but only one third of surprise medical bills were resolved satisfactorily. 

“These data confirm what we already knew anecdotally,” said Lynn Quincy, director of Altarum’s Healthcare Value Hub. “Virginians experience healthcare affordability problems and surprise medical bills at an alarming rate. Virginia residents would benefit significantly from state actions to alleviate these unfair and burdensome healthcare affordability problems.”

Advocates agree that even with Medicaid expansion, healthcare affordability is still a top issue for all Virginians. The Virginia Poverty Law Center (VPLC) has advocated for improved healthcare access for Virginia consumers – especially low-income consumers – for decades. Jill Hanken, VPLC health attorney, says “The ACA Marketplace and Virginia’s new Medicaid expansion have helped over 600,000 Virginians get health insurance.  But there are still many legitimate and urgent concerns about healthcare costs, access to services and medical debt.  This survey offers important support for new initiatives in Virginia to, for example, address premium costs and balance billing.” 

The Commonwealth Institute for Fiscal Analysis (TCI) has produced research and analyses on health care issues affecting low- and moderate-income Virginians since being founded over a decade ago and was an early voice advocating for Medicaid expansion. TCI President and CEO, Michael Cassidy, noted “the release of these survey results offer evidence that Virginia still has work to do in order to meet the health needs of all of those who live in the state. TCI is committed to continuing the work of identifying and advocating for policy solutions that advance equitable health access, affordability, and outcomes for Virginia families.”

“What is apparent to me from the CHESS findings is that Virginians are hungry for more information and tools to help them navigate the healthcare system to get the best care at the best value. They are also willing to take ownership of their health, with 60% agreeing that they could take better care of their personal health to help reduce affordability burdens,” said Beth Bortz, VCHI’s President and CEO. “Everyone has a role to play to reduce healthcare costs and improve value.  Providing consumers and health providers with information on the value of certain health care services is at the core of VCHI’s Smarter Care Virginia project and our Health Value Dashboard reports. We were thrilled to partner with the Altarum Healthcare Value Hub as the CHESS complements our existing work and offers another piece to the value puzzle.”

The data briefs are available at: and

About the Virginia Center for Health Innovation

Incorporated in January 2012 following a recommendation from Gov. Robert McDonnell’s Virginia Health Reform Initiative, the Virginia Center for Health Innovation (VCHI) seeks to facilitate innovation by convening key stakeholders and securing the resources to accelerate value-driven models of wellness and healthcare throughout Virginia. VCHI’s work is focused on achieving three aims: reducing low value health care, increasing high value health care, and ensuring Virginia has the infrastructure in place to measure and reward value in health care. Among its many innovative projects, the most notable for their alignment with this initiative are the Virginia Health Value Dashboard and the Virginia Scorecards on Payment Reform. For more information visit: and follow on Twitter, Facebook and LinkedIn.

About the Altarum HealthCare Value Hub

With support from the Robert Wood Johnson Foundation, the Healthcare Value Hubprovides free, timely information about the policies and practices needed to achieve health systems that are equitable, affordable, and focused on the goals and needs of the people the system is meant to serve. The Hub is part of Altarum, a nonprofit consulting and research organization that creates solutions to advance health of vulnerable and publicly insured populations.

Media Contacts:

Virginia Center for Health Innovation

Beth Bortz, President and CEO |


Tad Lee, Communications Leader |