Deductible double jeopardy: patients may pay more out of pocket when pregnancy crosses 2 years.
Am J Manag Care
; 30(6): 285-288, 2024 06.
Article
en En
| MEDLINE
| ID: mdl-38912954
ABSTRACT
OBJECTIVES:
This study explores the concern that annual high-deductible commercial insurance plan design may yield higher out-of-pocket costs when an episode of maternity care spans 2 years, exposing patients to their cost-sharing limits twice during their episode of care. STUDYDESIGN:
Cross-sectional study of Health Care Cost Institute commercial claims.METHODS:
The study sample comprises 1,379,300 deliveries among high-deductible health plan enrollees in years 2012 through 2021. Patients' mean cost sharing is calculated across all service types for 3 time periods (1) delivery hospitalization, (2) maternity episode from 40 weeks prior to delivery hospitalization through 12 weeks after discharge, and (3) extended period spanning 3 years from January of the year before delivery through December of the year after delivery.RESULTS:
For each of the 3 episode measurements, mean out-of-pocket spending is highest among those who deliver in January and declines in each subsequent month until August and September (the delivery months with most pregnancy and postpartum periods within the same year), then flattens for the remainder of the year. Mean cost sharing for the maternity episode was $6308 in January and $4998 in December, a difference of $1310. Patients delivering in January also had mean out-of-pocket costs $1491 greater for delivery hospitalization and $1005 greater over the 3-year period than patients delivering in December.CONCLUSIONS:
Higher out-of-pocket spending is observed when patients face their cost-sharing limits twice within an episode of maternity care, and this difference persists even when evaluating 3 calendar years of patients' out-of-pocket spending.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Seguro de Costos Compartidos
/
Gastos en Salud
/
Deducibles y Coseguros
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2024
Tipo del documento:
Article