Study: Poorer High-Deductible Plan Members May Skip Needed ED Care

Patients with low socioeconomic status enrolled in a high-deductible health plan may skip needed emergency care due to high out-of-pocket costs, which may lead to higher rates of hospitalization, according to a study in Health Affairs.

Researchers studied ED visits and hospitalizations of people enrolled in a high-deductible plan through small employers in Massachusetts over two years. The number of high-severity ED visits among enrollees of low socioeconomic status decreased 25 to 30 percent over both years. The number of hospitalizations of these patients decreased by 23 percent in the first year but increased to initial levels in the second year.

In contrast, high-deductible plan members of high socioeconomic status responded appropriately to their plan by reducing only low-severity ED visits.

The authors suggested policymakers and employers should educate high-deductible plan members, identify members at higher risk of avoiding necessary care and consider implementing means-based deductibles to limit deductibles for patients of low socioeconomic status.

More Articles on ED Utilization:

ER Wait Times Rise, Albeit Unequally, Across Nation
The Anatomy of a Successful ED Redesign
New Initiative to Help Safety Net Providers Build Capacity for Newly Insured

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