PDB103 - FINANCIAL ACCESS TO HEALTH CARE USE IN DIABETICS WITH HIGH-DEDUCTIBLE HEALTH PLAN (HDHP)

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

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Perceptions of Health Care Use in Germany during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249351 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9351

Author(s):

André Hajek ◽

Freia De Bock ◽

Lothar H. Wieler ◽

Philipp Sprengholz ◽

Benedikt Kretzler ◽

...

Keyword(s):

Health Care ◽

Regression Analysis ◽

Medical Care ◽

Access To Health Care ◽

Healthcare Services ◽

Access To Healthcare ◽

Health Care Use ◽

Access To Health ◽

Using Data ◽

Perceived Access

This paper examined the determinants of perceived access to health care use during the COVID-19 pandemic in Germany using data from two waves (8 and 16) of the COVID-19 Snapshot Monitoring (COSMO). Descriptive and regression analysis were used. In wave 8, we found that about 60% of the individuals rather disagreed about having had problems accessing medical care. Furthermore, 73% of the individuals rather disagreed to having experienced health deteriorations due to restrictions on the availability of medical care. Moreover, 85% of the individuals were rather optimistic about future access to healthcare services. Overall, slightly better past and future access to healthcare services has been reported in wave 16. Several determinants were identified in regression analysis. In conclusion, data suggest that perceived past and future access to healthcare services during the COVID-19 pandemic is reasonably good.

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Economics Risks of and Growth of the High Deductible Health Plan Among Patients With Cognitive Impairment

Innovation in Aging ◽

10.1093/geroni/igaa057.338 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 102-103

Author(s):

Kevin Lu ◽

Sam Li ◽

Jing Yuan ◽

Minghui Li

Keyword(s):

Health Care ◽

Cognitive Impairment ◽

Health Plan ◽

Unintended Consequences ◽

Financial Access ◽

Effective Care ◽

Confounding Variables ◽

Interview Survey ◽

High Deductible Health Plan ◽

Care Costs

Abstract OBJECTIVES: High Deductible Health Plan (HDHP) is characterized by higher deductibles and lower monthly premiums. Nevertheless, health economists are concerned that HDHPs may reduce or delay needed care, which will ultimately lead to poorer access to care for chronically affected participants. The objectives of this research are 1) to investigate the HDHP enrollment trend over the past decade; and, 2) to determine the effects of HDHP on risks of financial access risks among adults with cognitive impairment (CI). METHODS: Data were obtained between 2010-2018 from National Health Interview Survey (NHIS). Financial access to healthcare was assessed based on 6 survey questions by CDC. For data analysis, simple T tests and Chisq tests were used where appropriate, with multi-variable logistic regressions implemented to evaluate the effects of HDHP on risks of financial access. RESULTS: Of the 103,649 enrollments, 1,148 were with cognitive impairment and 102,501 were without CI diagnosis. A 55% increase in HDHP registers with cognitive impairment was observed from 2010 (30.50%) to 2018 (47.24%). After controlling for confounding variables, patients with HDPHs were more likely to have risks of financial access compared to those without HDHP (OR= 1.313, 95% CI, 1.002-1.719, p=0.0483). CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. Our research among CI patients with HDHP experienced more financial access risks than those without HDHP, indicating that HDHPs might have unintended consequences of healthcare usage. Employers and health care decision-makers may need to consider providing compensation to those HDHP enrollers with CI.

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