Health Care Use And Spending Patterns Vary By Wage Level In Employer-Sponsored Plans.

Employees face an increasing financial burden for health services as health care costs increase relative to earnings. Yet little is known about health care utilization patterns relative to employee wages. To better understand this association and the resulting implications, we examined patterns of h...

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Published in:Health Affairs Vol. 36; no. 2; pp. 250 - 258
Main Authors: Sherman, Bruce W., Gibson, Teresa B., Lynch, Wendy D., Addy, Carol
Format: research tables/charts Journal Article
Published: Health Affairs Publishing, LLC Feb2017
Online Access:View this record in EBSCOhost
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      dt: Feb2017
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      pub: Health Affairs Publishing, LLC
      place: Washington, District of Columbia
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        10.1377/hlthaff.2016.1147
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        atl: Health Care Use And Spending Patterns Vary By Wage Level In Employer-Sponsored Plans.
      aug:
        au:
          Sherman, Bruce W.
          Gibson, Teresa B.
          Lynch, Wendy D.
          Addy, Carol
        affil: Medical director, population health management at Conduent HR Services, Cleveland, Ohio
      sug:
        subj:
          Patient Care Plans
          Salaries and Fringe Benefits
          Health Care Costs
          Health Resource Utilization
          Employment
          Human
          Health Benefit Plans, Employee
          Health Insurance Exchanges
          Healthcare Disparities
          Health Status Disparities
          Patient Admission
          Emergency Service Utilization
          Socioeconomic Factors
          Insurance Coverage
          Logistic Regression
          Male
          Female
          Adolescence
          Young Adult
          Adult
          Middle Age
          Age Factors
          Sex Factors
          Scales
          Cross Sectional Studies
          Preventive Health Care
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Employees face an increasing financial burden for health services as health care costs increase relative to earnings. Yet little is known about health care utilization patterns relative to employee wages. To better understand this association and the resulting implications, we examined patterns of health care use and spending by wage category during 2014 among 42,936 employees of four self-insured employers enrolled in a private health insurance exchange. When demographics and other characteristics were controlled for, employees in the lowest-wage group had half the usage of preventive care (19 percent versus 38 percent), nearly twice the hospital admission rate (31 individuals per 1,000 versus 17 per 1,000), more than four times the rate of avoidable admissions (4.3 individuals per 1,000 versus 0.9 per 1,000), and more than three times the rate of emergency department visits (370 individuals per 1,000 versus 120 per 1,000) relative to top-wage-group earners. Annual total health care spending per patient was highest in both the lowest-wage ($4,835) and highest-wage ($5,074) categories relative to the middle two wage groups ($3,952 and $3,987, respectively). These findings provide new insights about wage-associated variations in health care use and spending in employer-sponsored plans. For policy makers, these findings can inform employer benefit design strategies and research priorities, to encourage effective use of health care services.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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