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- W2804126777 abstract "Rates of insurance coverage in high deductible health plans (HDHP) and deductible size have been increasing. Over-time, financial barriers can lead to a substantial reduction in opportunities for health promotion and care coordination. We investigated the impact of different types of HDHPs on primary and specialty services utilization and receipt of preventive services among adult (18-64 years) privately insured respondents using pooled 2011-2014 Medical Expenditure Panel Survey (MEPS). The sample (n = 25,965) was divided into four insurance types (1) no deductible (ND) (2) low deductible (LD), (3) high deductible with health savings account (HD-HSA), and (4) high deductible without health savings account (HD-NoHSA). Multivariable regression models were estimated, adjusting for demographic characteristics and health status. Number of visits to primary care physicians and specialists were lowest for persons in the HD-NoHSA group (IRR 0.88 95% CI [0.81-0.96]). HD-NoHSA beneficiaries had lower rates of receiving hypertension screening (IRR 0.97 95% CI [0.94-0.99]) and flu vaccination (IRR 0.92 95% CI [0.86-1.00]) when compared to ND enrollees. Female respondents in the HD-NoHSA group were 7% less likely to receive mammograms (IRR 0.93 95% CI [0.89-0.98]) compared to the ND group. There was no significant association between insurance type and the other preventive service measures. Higher deductibles significantly decrease opportunities for early detection and management of chronic diseases, immunizations and care coordination. Fiscal barriers to essential medical care should be eliminated at least for those most vulnerable." @default.
- W2804126777 created "2018-06-01" @default.
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- W2804126777 date "2018-05-23" @default.
- W2804126777 modified "2023-09-26" @default.
- W2804126777 title "Privately insured adults in HDHP with higher deductibles reduce rates of primary care and preventive services" @default.
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- W2804126777 doi "https://doi.org/10.1093/tbm/ibx076" @default.
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