Out-of-Pocket Costs Burden in Marketplace Plans for People With Diabetes.

Background: The Affordable Care Act (ACA) aims to expand coverage and increase access to health insurance. Despite the increase of insured individuals, there are a number of concerns about whether coverage and care are affordable. Prior studies document a growing concern with rising premiums and cos...

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Publicado en:Health Services Insights pp. 1 - 9
Autores principales: Ruscitti, Brielle, Kern, Caroline, Bowser, Diana
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 12/3/2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 12/3/2024
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      pub: Sage Publications Inc.
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        atl: Out-of-Pocket Costs Burden in Marketplace Plans for People With Diabetes.
      aug:
        au:
          Ruscitti, Brielle
          Kern, Caroline
          Bowser, Diana
        affil: William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
      sug:
        subj:
          Health Care Costs Economics
          Insurance, Health Economics
          Diabetes Mellitus Economics
          Economic Aspects of Illness
          Needs Assessment
          Patient Protection and Affordable Care Act
          Health Insurance Exchanges
          Human
          Descriptive Research
          Costs and Cost Analysis
          Rural Areas
          Urban Areas
          Income
          Insurance Coverage
          Descriptive Statistics
          T-Tests
          United States
      ab: Background: The Affordable Care Act (ACA) aims to expand coverage and increase access to health insurance. Despite the increase of insured individuals, there are a number of concerns about whether coverage and care are affordable. Prior studies document a growing concern with rising premiums and cost-sharing, including deductibles, particularly for those with chronic conditions. Objective: Compare the ACA marketplace plan availability and costs across 17 states for individuals with varying diabetic engagement profiles and their related medical needs. Design: Descriptive Cost Analysis. Methods: Using Healthcare.gov individual state marketplace websites, we utilized a descriptive cost analysis to compare plan availability and costs for premiums, deductibles, co-payments, and co-insurance for an individual aged 63 years old, who was either a non-diabetic, high-engagement or low-engagement diabetic in urban and rural areas. Using the second lowest monthly premium silver plan (the benchmark plan), we calculated annual costs for premiums, co-insurance, co-payments, and deductibles for these individual profiles. We assessed statistical differences between health care component costs, within and across urban and rural areas, using t -tests. Results: The findings highlight within and across states, individuals with diabetes, particularly low-engagement diabetics, spend a significantly higher percent of their income on additional health care costs, above their premium, than non-diabetic individuals. In some states, low-engagement diabetic patients spend upwards of 3 times more than high-engagement diabetic patients, highlighting an additional cost burden. For low-engagement diabetics, deductibles are driving health care spending with an average of 59% of health care spending coming from deductible payments. Results do not show statistically different costs across urban and rural diabetic patients. Conclusion: Despite the ACA's success, results highlight variation in plan availability across states and disproportionate cost burden placed on moderate income individuals, especially related to deductible, and co-payments for those with chronic diseases.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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