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Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment

BACKGROUND: High-deductible health plans (HDHPs) are characterized by higher deductibles and lower monthly premiums compared with a typical health plan. HDHPs may reduce, or delay, needed care, which will ultimately lead to poorer access to care for chronically affected participants. OBJECTIVES: To...

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Autores principales: Alnijadi, Abdulrahman A, Li, Minghui, Wu, Jun, Xiong, Xiaomo, Lu, Z Kevin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372991/
https://www.ncbi.nlm.nih.gov/pubmed/34949113
http://dx.doi.org/10.18553/jmcp.2022.28.1.07
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author Alnijadi, Abdulrahman A
Li, Minghui
Wu, Jun
Xiong, Xiaomo
Lu, Z Kevin
author_facet Alnijadi, Abdulrahman A
Li, Minghui
Wu, Jun
Xiong, Xiaomo
Lu, Z Kevin
author_sort Alnijadi, Abdulrahman A
collection PubMed
description BACKGROUND: High-deductible health plans (HDHPs) are characterized by higher deductibles and lower monthly premiums compared with a typical health plan. HDHPs may reduce, or delay, needed care, which will ultimately lead to poorer access to care for chronically affected participants. OBJECTIVES: To (1) investigate the HDHP enrollment trend and (2) determine the effects of HDHPs on financial access problems for individuals with self-reported cognitive impairment. METHODS: Data between 2010 and 2018 were obtained from the National Health Interview Survey (NHIS). Individuals with cognitive impairment were identified if they were limited by memory difficulties. Problems regarding financial access to health care were assessed based on 6 survey questions from the Centers for Disease Control and Prevention. Multivariable logistic regressions were implemented to evaluate the effects of HDHPs. RESULTS: This study identified 1,148 individuals with cognitive impairment, representing 3.9 million individuals in the United States from 2010 to 2018. A nearly 2-fold increase in HDHP enrollment with cognitive impairment was observed from 2010 (20.9%) to 2018 (41.9%). This increase is similar to that reported for noncognitively impaired individuals. After controlling for possible confounding variables, cognitively impaired individuals with HDPHs were more likely to have overall financial access difficulties compared with those without HDHPs (OR = 1.17, 95% CI = 0.88-1.56, P = 0.271), but this likelihood was not statistically significant. CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. However, our research found that among individuals with cognitive impairment, those with HDHPs experienced some financial access problems, such as affording medical care, follow-up care, and specialists, than those without HDHPs, indicating that HDHPs might have unintended consequences for health care usage.
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spelling pubmed-103729912023-07-31 Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment Alnijadi, Abdulrahman A Li, Minghui Wu, Jun Xiong, Xiaomo Lu, Z Kevin J Manag Care Spec Pharm Research BACKGROUND: High-deductible health plans (HDHPs) are characterized by higher deductibles and lower monthly premiums compared with a typical health plan. HDHPs may reduce, or delay, needed care, which will ultimately lead to poorer access to care for chronically affected participants. OBJECTIVES: To (1) investigate the HDHP enrollment trend and (2) determine the effects of HDHPs on financial access problems for individuals with self-reported cognitive impairment. METHODS: Data between 2010 and 2018 were obtained from the National Health Interview Survey (NHIS). Individuals with cognitive impairment were identified if they were limited by memory difficulties. Problems regarding financial access to health care were assessed based on 6 survey questions from the Centers for Disease Control and Prevention. Multivariable logistic regressions were implemented to evaluate the effects of HDHPs. RESULTS: This study identified 1,148 individuals with cognitive impairment, representing 3.9 million individuals in the United States from 2010 to 2018. A nearly 2-fold increase in HDHP enrollment with cognitive impairment was observed from 2010 (20.9%) to 2018 (41.9%). This increase is similar to that reported for noncognitively impaired individuals. After controlling for possible confounding variables, cognitively impaired individuals with HDPHs were more likely to have overall financial access difficulties compared with those without HDHPs (OR = 1.17, 95% CI = 0.88-1.56, P = 0.271), but this likelihood was not statistically significant. CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. However, our research found that among individuals with cognitive impairment, those with HDHPs experienced some financial access problems, such as affording medical care, follow-up care, and specialists, than those without HDHPs, indicating that HDHPs might have unintended consequences for health care usage. Academy of Managed Care Pharmacy 2022-01 /pmc/articles/PMC10372991/ /pubmed/34949113 http://dx.doi.org/10.18553/jmcp.2022.28.1.07 Text en Copyright © 2022, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Research
Alnijadi, Abdulrahman A
Li, Minghui
Wu, Jun
Xiong, Xiaomo
Lu, Z Kevin
Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title_full Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title_fullStr Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title_full_unstemmed Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title_short Trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
title_sort trend and effects of high-deductible health insurance plans in the health care system: financial access problems in management of cognitive impairment
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372991/
https://www.ncbi.nlm.nih.gov/pubmed/34949113
http://dx.doi.org/10.18553/jmcp.2022.28.1.07
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