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Health Care Financing Practices Among U.S. Amish.

Evan J Beck1, Kevin E Kucharski2, Kiri E Sunde3

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Amish communities often use mutual aid for healthcare, but cost concerns lead some to avoid care. Understanding these unique financing methods is crucial for providers.

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AmishHealth care financingSelf-paySurvey

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Area of Science:

  • Sociology of Health
  • Public Health Policy
  • Healthcare Economics

Background:

  • The Amish, a growing ethnoreligious group, traditionally use community-based mutual aid for healthcare financing.
  • Limited understanding exists regarding the cost, structure, and effectiveness of these Amish mutual aid programs.

Purpose of the Study:

  • To describe the characteristics and financial mechanisms of Amish mutual aid healthcare organizations.
  • To assess the perceived efficacy and challenges of these programs, including cost-related barriers to care.

Main Methods:

  • A survey of 1006 Amish households across 12 states was conducted using a 31-question instrument.
  • Statistical analysis was performed on the 155 returned surveys (15.4% response rate).

Main Results:

  • 81% of respondents participated in mutual aid organizations, with annual healthcare spending varying from $500 to $18,000.
  • Over 90% trusted community support for healthcare costs, yet 39% sometimes avoided care due to expense.
  • Significant regional differences in cost avoidance and affordability perceptions were noted among Amish populations.

Conclusions:

  • Amish mutual aid for healthcare is prevalent, utilizing diverse financing models like subscriptions and donations.
  • The success of these organizations is influenced by population distribution and health system integration.
  • Healthcare providers need to understand Amish financial practices for effective patient billing and care coordination.