High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products. If the current growth rate of enrollment in these plans continues, 25% of your patients will be presenting with this coverage in fewer than six years. Mishandling these products can cause unnecessary cash flow issues, but a little proactivity, education, and training now, will go a long way.
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High-Deductible Health Insurance May Exacerbate Racial And Ethnic Wealth Disparities.
Health Aff (Millwood)
October 2024
Sherry A. Glied, New York University, New York, New York.
This study examined the equity implications of high-deductible health plans within the context of racial and ethnic wealth disparities. Using restricted data from the Medical Expenditure Panel Survey, we evaluated the net worth (in 2011-18) and financial assets (in 2011-16) of families with private insurance and those in high-deductible health plans with and without an associated health savings account. Our results represent, to our knowledge, the first estimates of racial and ethnic wealth disparities within these populations.
View Article and Find Full Text PDFThe impact of telehealth cost-sharing on healthcare utilization: Evidence from high-deductible health plans.
Health Serv Res
December 2024
Economics, Sociology, and Statistics (ESS), RAND Corporation, Santa Monica, California, USA.
Objective: Evaluate whether cost-sharing decreases led high-deductible health plans (HDHP) enrollees to increase their use of healthcare.
Data Sources, Study Setting: National sample of chronically-ill patients age 18-64 from 2018 to 2020 (n = 1,318,178).
Study Design: Difference-in-differences analyses using entropy-balancing weights were used to evaluate the effect of a policy shift to $0 cost-sharing for telehealth on utilization for HDHP compared with non-HDHP enrollees.
Ambulatory Surgery Centers Reduce Patient Out-of-Pocket Expenditures for Isolated Arthroscopic Rotator Cuff Repair, but Patient Out-of-Pocket Expenditures Are Increasing at a Faster Rate Than Total Healthcare Utilization Reimbursement From Payers.
Arthroscopy
June 2024
Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.. Electronic address:
Purpose: To categorize and trend annual out-of-pocket expenditures for arthroscopic rotator cuff repair (RCR) patients relative to total healthcare utilization (THU) reimbursement and compare drivers of patient out-of-pocket expenditures (POPE) in a granular fashion via analyses by insurance type and surgical setting.
Methods: Patients who underwent outpatient arthroscopic RCR in the United States from 2013 to 2018 were identified from the IBM MarketScan Database. Primary outcome variables were total POPE and THU reimbursement, which were calculated for all claims in the 9-month perioperative period.
Deductible double jeopardy: patients may pay more out of pocket when pregnancy crosses 2 years.
Am J Manag Care
June 2024
USC Schaeffer Center for Health Policy & Economics, 635 Downey Way, VPD 414F, Los Angeles, CA 90089-3333. Email:
Objectives: This study explores the concern that annual high-deductible commercial insurance plan design may yield higher out-of-pocket costs when an episode of maternity care spans 2 years, exposing patients to their cost-sharing limits twice during their episode of care.
Study Design: Cross-sectional study of Health Care Cost Institute commercial claims.
Methods: The study sample comprises 1,379,300 deliveries among high-deductible health plan enrollees in years 2012 through 2021.
Insurer-Mandated Medication Utilization Barriers are Associated With Decreased Insurance Satisfaction and Adverse Clinical Outcomes: An Inflammatory Bowel Disease Partners Survey.
Am J Gastroenterol
October 2024
Department of Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA .
Introduction: Insurer-mandated barriers to timely initiation of advanced therapies used to treat inflammatory bowel disease (IBD) have been shown to worsen clinical outcomes and increase healthcare utilization, yet rarely alter the medication ultimately prescribed.
Methods: We conducted a survey within the IBD Partners longitudinal cohort to evaluate the frequency and patient-reported impacts of medication utilization barriers on insurance satisfaction and clinical outcomes. Barriers included medication denials, prior authorizations, and forced medication switches.
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