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Completed

NCT Number: NCT04835012

Health and Health Care Utilization Effects of Medical Debt Forgiveness

The goal of this study is to estimate the direct, causal impact of medical debt on health care utilization, mental health, and wellbeing of patients. The investigators will conduct a survey to measure the impact of the debt forgiveness on health care use, mental health, and wellbeing. The survey will be administered to approximately 17,000 subjects of a recent medical financial intervention. In that prior intervention, a non-profit charity, RIP Medical Debt, purchased and abolished medical debt for a randomly selected about 6,000 (out of the 17,000) individuals. In this current protocol, the investigators will administer the survey, and will compare surveyed outcomes of subjects who received and did not receive the intervention.

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Key information

Conditions

Health Care Utilization Anxiety Anxiety Disorders Behavior Behavioral Symptoms Depression Health Behavior Mental Disorders Patient Acceptance of Health Care Personal Satisfaction Psychological Well-Being Subjective Wellbeing Treatment Adherence and Compliance

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Wesley Yin

Los Angeles, California, 90095, United States

About this study

This study will estimate the direct, causal impact of medical debt on health care utilization, mental health, and wellbeing of patients. To do so, the investigators will administer a survey to approximately 17,000 subjects of a recent medical financial intervention. In that intervention, a non-profit charity, RIP Medical Debt, purchased and abolished medical debt for a randomly selected about 6,000 (out of the 17,000) study subjects. In this current protocol, the investigators will compare surveyed outcomes of subjects who received and did not receive the medical debt abolishment intervention. Because debt abolishment was randomized, comparing surveyed outcomes of treated and control subjects in the cross-section will allow the study to estimate the causal impact of the medical debt abolishment. The survey will measure the effects of medical debt on three sets of outcomes: (i) health care utilization, as measured by medical care visits, prescription drug utilization and adherence, and unmet need for medical care; (ii) mental health, as measured by validated screens for depression and anxiety; and (iii) subjective wellbeing, as measured by self-reported health, forgone consumption, and financial strain. This study would be the first to provide a direct, causal connection between the rising personal debt associated with U.S. health care and the health outcomes of its recipients.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Individuals ages 18 and over who owed medical debt to FFAM, a debt collections agency

Exclusion criteria

  • Excluded individuals who owed less than $500 in medical debt to FFAM
  • Excluded individuals with missing social security numbers

Treatment and study plan

Medical debt forgiveness

Other

A non-profit charity, RIP Medical Debt, bought and retired medical debt for individuals that were assigned to the treatment group.

Primary outcomes

  1. 8-item Patient Health Questionnaire (PHQ-8) Depression Scale

    Time frame: An average of 12 months after the intervention.

    Scores on the 8-item Patient Health Questionnaire depression scale range from 0 to 24, with higher scores indicating greater severity of depression.

Secondary outcomes

  1. Received Needed Health Care

    Time frame: An average of 12 months after the intervention.

    Binary response to: "If you needed medical care in the last 12 months, did you get ALL the medical care you needed?" (Health Care Utilization domain)

  2. Received Needed Rx

    Time frame: An average of 12 months after the intervention.

    Binary response to: "If you needed prescription medications in the last 12 months, did you get all the prescription medications you needed?" (Health Care Utilization domain)

  3. 7-item Generalized Anxiety Disorder (GAD7) Scale

    Time frame: An average of 12 months after the intervention.

    Scores on the 7-item Generalized Anxiety Disorder Scale range from 0 to 21, with higher scores indicating greater severity of anxiety (Mental Health Domain).

  4. Stress

    Time frame: An average of 12 months after the intervention.

    Binary response to: "Stress means a situation in which a person feels tense, restless, nervous or anxious or is unable to sleep at night because his/her mind is troubled all the time. Do you feel this kind of stress these days?" (Mental Health Domain)

  5. General Health

    Time frame: An average of 12 months after the intervention.

    Response to: "In general, would you say your health is: Excellent, Very Good, Good, Fair, or Poor?" (General Health Domain)

  6. Happiness

    Time frame: An average of 12 months after the intervention.

    Response to: "Taken all together, how would you say things are these days - would you say that you are Very Happy, Pretty Happy, or Not Too Happy?" (Subjective Wellbeing Domain)

  7. Problems paying other bills

    Time frame: An average of 12 months after the intervention.

    Response to: "Besides medical bills, have you had problems paying other types of bills in the past 12 months?" (Financial Stress Domain)

  8. Changes in spending due to medical debt

    Time frame: An average of 12 months after the intervention.

    Indexed response to: "As a result of medical bills have you cut back on spending in the past 12 months on i) basic necessities (like food, heat or housing, or other basic household items), ii) Big-ticket items (like cars, furniture, or appliances); iii) business investments?" (Financial Stress Domain)

  9. Changes in borrowing due to medical debt

    Time frame: An average of 12 months after the intervention.

    Indexed response to: "As a result of medical bills, in the past 12 months, have you i) Increased your credit card debt, or charge card debt? ii) Borrowed money from a payday lender?; iii) Borrowed from friends and family?; iv) Used up all or most of your savings?; v) Increased debt on other lines of credit?" (Financial Stress Domain)

Sponsors and collaborators

Lead sponsor

University of California, Los Angeles

Other

Collaborators

  • Abdul Latif Jameel Poverty Action Lab
  • National Institutes of Health (NIH)
  • National Opinion Research Center
  • Stanford University

Registry information

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Apr 8, 2021
Registry last updated
Apr 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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