High-deductible health plans probably not best choice for COPD patients, study finds

Patients with chronic obstructive pulmonary disease who are enrolled in a private high-deductible health plans are more likely than those with traditional deductible coverage to face cost-related healthcare access problems, grapple with financial strain and visit emergency rooms, according to a new Harvard study.

The study — published Oct. 10 in the Annals of the American Thoracic Society — examined 2,137 privately insured COPD patients, ages 40-64, in the CDC's 2011-2017 National Health Interview Survey. More than 1,330 patients had a traditional health plan and more than 800 had high-deductible coverage.

Five findings:

1. Among COPD patients in high-deductible plans, 28.9 percent reported they had forgone or delayed medical care due to costs in the last 12 months. That's compared to 16 percent of those with traditional deductible coverage.

2. About 20 percent of COPD patients in high-deductible plans said they took less medicine than needed in the last 12 months to save money — more than those with traditional plans (11 percent).

3. About 21 percent of COPD patients in high-deductible plans reported family out-of-pocket annual medical spending exceeding $5,000 (excluding premiums). That's compared to 8 percent of those with traditional deductible coverage.

4. About a third of COPD patients in high-deductible plans (32.9 percent) reported struggles paying family medical bills, compared to 20.7 percent of those with traditional coverage.

5. Overall, the study found that COPD patients in high-deductible plans were more likely than those with traditional coverage to be hospitalized or visit the ER in the last year.

"COPD is not an easy disease to live with," lead study author Adam Gaffney, MD, a pulmonary and critical care physician and an instructor in medicine at Harvard Medical School, said. "But treatment can help, assuming patients can afford it. Yet our study shows that patients with COPD who are privately insured, especially those with high deductibles, aren't getting the care they need — with dangerous consequences for their health."

 

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