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...
| Publicado en: | Health Services Insights pp. 1 - 9 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
12/3/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181276456&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181276456 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11786329 B10H jtl: Health Services Insights issn: 11786329 maglogo: Y pubinfo: dt: 12/3/2024 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 181276456 181276456 181276456 10.1177/11786329241304618 181276456 ppf: 1 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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