Financial Risk for COVID-19-like Respiratory Hospitalizations in Consumer-Directed Health Plans
Financial Risk for COVID-19-like Respiratory Hospitalizations in Consumer-Directed Health Plans
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DOI：
10.1016/j.amepre.2020.05.008
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发表时间：
2020-09-01
影响因子：
5.5
通讯作者：
Kennedy-Hendricks, Alene
中科院分区：
文献类型：
--
作者：
Eisenberg, Matthew D.;Barry, Colleen L.;Kennedy-Hendricks, Alene
简介：这项研究旨在量化与2019年冠状病毒病引起的呼吸系统住院相关的自付支出，并比较参加消费者导向健康计划和传统低免赔额计划的自付支出差异。方法：本研究使用OptumLabs数据仓库（2016年1月1日至2019年8月31日）中的去识别管理索赔来识别呼吸系统住院患者。它比较了消费者导向的健康计划注册者与传统计划注册者之间的未经调整的自付支出，使用平均显著性差异检验，并按年龄类别和日历年季度分别重复分析。这些数据由OptumLabs滚动收集，并于2020年3月进行了分析。结果：商业保险消费者导向健康计划投保人的自付支出显著高于传统计划投保人，这些差异在年轻人群中最大。自付支出的最大差异发生在今年上半年。结论：2019年冠状病毒病相关住院治疗可能会给消费者导向健康计划参保者带来不同的经济负担。尽管一些保险公司正在免除2019年冠状病毒病治疗的费用分摊，但自我保险的雇主仍然可以免除。截至目前，政策反应可能不足以减轻2019年冠状病毒病相关呼吸道住院的消费者导向健康计划参与者的经济负担。(C)2020年美国预防医学杂志。爱思唯尔公司出版All rights reserved.
Introduction: This study aims to quantify out-of-pocket spending associated with respiratory hospitalizations for conditions similar to those caused by coronavirus disease 2019 and to compare out-of-pocket spending differences among those enrolled in consumer-directed health plans and in traditional, low-deductible plans.Methods: This study used deidentified administrative claims from the OptumLabs Data Warehouse (January 1, 2016-August 31, 2019) to identify patients with a respiratory hospitalization. It compared unadjusted out-of-pocket spending among consumer-directed health plan enrollees with that among traditional plan enrollees using difference of mean significance tests and repeated the analysis separately by age category and calendar year quarter. These data were collected on a rolling basis by OptumLabs and were analyzed in March 2020.Results: Commercially insured consumer-directed health plan enrollees had significantly higher out-of-pocket spending than traditional plan enrollees, and these differences were largest among younger populations. The largest difference in out-of-pocket spending occurred during the first half of the year.Conclusions: Consumer-directed health plan enrollees may experience differential financial burden from a hospitalization related to coronavirus disease 2019. Although some insurers are waiving cost-sharing payments for coronavirus disease 2019 treatment, self-insured employers remain exempt. As of now, policy responses may be insufficient to reduce the financial burden on consumer-directed health plans enrollees with respiratory hospitalizations related to coronavirus disease 2019. (C) 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.