Delays experienced with high-deductible health plans
A new study in the US has found that a population of people with diabetes who were switched to high-deductible health plans – i.e. those with lower premiums and higher deductibles – had associated delays in care for dangerous blood vessel diseases. The study, entitled High-deductible Insurance and Delay in Care for the Macrovascular Complications of Diabetes, was recently published in Annals of Internal Medicine.
A new study in the US has found that a population of people with diabetes who were switched to high-deductible health plans – i.e. those with lower premiums and higher deductibles – had associated delays in care for dangerous blood vessel diseases. The study, entitled High-deductible Insurance and Delay in Care for the Macrovascular Complications of Diabetes, was recently published in Annals of Internal Medicine.
In order to determine whether high-deductible insurance is associated with delays in medical care for symptoms of cardiovascular, cerebrovascular, and peripheral vascular disease and related testing and treatment, researchers used data from a large national health insurance plan. The study analysed care data for individuals with diabetes in employer-sponsored insurance plans who were enrolled in a low-deductible (under US$500) insurance plan, followed by up to four years in a high-deductible (over $1,000) plan after an employer-mandated switch. There was also a control group, which included individuals with diabetes whose employers offered only low-deductible plans year-on-year.
The results showed that, among individuals with diabetes, mandated enrolment in a high-deductible insurance plan was associated with delays in seeking care for concerning symptoms of blood vessel disease such as cardiac chest pain and transient ischaemic attack. The team also found delays in diagnostic testing for such symptoms, and delays in treatments to open the arteries that supply the heart, brain and legs.
This led the researchers to deduce that diabetes patients who are switched to high-deductible health plans change their healthcare behaviour in response to the increased out-of-pocket costs they face for medical services. “Further research should determine if these delays increase adverse events such as heart attacks, strokes, and amputations,” said Frank Wharam, lead author and Associate Professor of Population Medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute. “Policymakers, health insurers and employers might find our results useful in designing health insurance plans that prevent the types of delays we detected.”