Navigation Links
Low-income families with sick children often enrolled in high-deductible health care plans

High-deductible health plans are increasingly used by healthy people who are unlikely to incur high medical expenses. But they also end up enrolling many low-income, vulnerable families, finds a study of Massachusetts families from Children's Hospital Boston and Harvard Medical School's Department of Ambulatory Care and Prevention (DACP). The study appears in the April issue of the journal Pediatrics.

The researchers, led by Alison Galbraith, MD, MPH, and Tracy Lieu, MD, MPH, both of Children's and the DACP, used enrollment and claims data from Harvard Pilgrim Health Care, a large New England health plan. They identified 839 families with children who initially had traditional health maintenance organization plans through Harvard Pilgrim, but whose employers later switched them to a high-deductible health plan when Harvard Pilgrim began offering it. They compared this group with 5,133 families whose employers stayed with the traditional plan, to see what kinds of families were most likely to be switched to high-deductible plans.

Overall, about a third of those who were switched to high-deductible plans had a child with a chronic condition, 13 percent lived in neighborhoods with high poverty, 36 percent had an above-average burden of illness, 19 percent incurred large health-care costs at baseline (more than $7,000 a year, including out-of-pocket costs).

"The usual assumption is that high-deductible plans attract healthy and wealthy people, based on studies of people who chose those plans themselves," says Galbraith. "Our population only had one plan offered to them and we found that many of those who were switched to high-deductible plans had children with chronic conditions. There wasn't a difference in the amount of chronic illness between the high-deductible and traditional families, but it was striking that there wasn't less illness in the high-deductible group. We need to be aware of this as these plans become more popular."

When the same data were analyzed by size of employer, an interesting split emerged:

Among the families with large employers, those living in high-poverty neighborhoods were 1.78 times more likely than families in higher-income areas to be switched to a high-deductible plan, after adjustment for other factors (including level of education, known chronic conditions, overall health burden and health costs incurred).

Families with small employers were *less* likely to be switched to high-deductible plans if they had more children, an above-average burden of illness and higher health-care expenditures at baseline. Those who *were* switched tended to be healthier and have fewer children.

"Our data show that families with children in high-deductible plans may comprise two distinct groups, one with higher-risk characteristics and one with lower-risk characteristics compared to traditional plans," says Galbraith. "This makes it important to monitor the effects of enrollment in high-deductible plans on children's use of needed care, especially for vulnerable populations that are enrolled."

As high-deductible health plans have become more popular, with 10 percent of employers offering a plan with a high deductible and 14.8 million adults enrolled in 2007(1,2), they are also spreading to families with children. There is growing concern among pediatricians that families facing high out-of-pocket costs may be failing to obtain recommended care.

A national survey published in 2007(2) showed that about half of the people enrolled in high-deductible plans did not have a choice of plans.


Contact: Rob Graham
Children's Hospital Boston

Related medicine news :

1. Missing: 125 Million Meals for Low-Income Minnesotans
2. Area Dentists, University of Detroit Mercy Team Up to Provide Free Dental Care to Low-Income, Uninsured Detroit-Area Children on Saturday, February 7
3. Michigan Dentists Giving Free Dental Care to Low-Income Children During Annual Give Kids a Smile Program Starting February 6
4. ADA Give Kids A Smile Events Provide Dental Care to Children from Low-Income Families
5. Catholic Charities USA Praises Congress for Protecting Health Care for Low-income Children
6. Obesity among states low-income teens nearly triple that of more affluent peers
7. Current Economic Situation Prompts Increased Smoking, Delay in Quit Attempts, Middle and Low-Income Americans Hit Hardest
8. AHIP: Low-Income and Rural Seniors Depend on Medigap Supplemental Coverage
9. Parenting program for low-income families reduces toddlers problem behavior
10. Kids of Stressed, Low-Income Moms Prone to Weight Problems
11. West Coast Bank Sponsors LifeWorks Northwest Programs for Children in Low-Income Housing Communities
Post Your Comments:
(Date:12/1/2015)... ... ... is the first health care provider in the region to offer the vBloc® Therapy ... vagal blocking therapy, delivered via the Maestro® System, for the treatment of adult patients over ... to 45 kg, or a BMI of at least 35 to 39.9 kg with a ...
(Date:12/1/2015)... ... December 01, 2015 , ... Dr. Paul Vitenas, one of the ... been named by MedEsthetics magazine as the Best Single Physician Practice in the nation. ... many elite aesthetic physicians honored by the industry publication. , Dr. Vitenas said ...
(Date:12/1/2015)... Delaware (PRWEB) , ... December 01, 2015 , ... ... winner at the 7th Annual 2015 Golden Bridge Business Awards under the New ... is a zero capex web based sample management software that helps ...
(Date:12/1/2015)... ... 2015 , ... For many X-rays taken at hospitals, doctors’ ... by the radiologist. The marking utensils are so small, however, they are difficult ... way to alleviate this problem. , He developed the patent-pending MARK N SHOW ...
(Date:12/1/2015)... ... December 01, 2015 , ... ... it has been awarded a fixed price per sprint agile development contract to ... at $34 million over five years, provides software engineering, infrastructure, as well as ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... Pa. , Dec. 1, 2015  Today, ... announced the launch of CareFront, a first-of-its-kind population ... patients diagnosed with cancer. Designed to be built ... diagnosed cancer patients with resources for their care ... The program also offers tools to help patients ...
(Date:12/1/2015)... , Dec. 1, 2015   Craneware, ... value cycle solutions, today announced the company will ... Pharmacy ChargeLink ® solution at the ... Midyear Clinical Meeting . The new features are ... process of monitoring and managing enterprise-wide pharmacy charges ...
(Date:12/1/2015)... 1, 2015  Booth #3506 – Claymount is featuring its ... meeting of the Radiological Society of North America ... year. Based in the Netherlands , Claymount ... Systems (NYSE: VAR ) and is one of the ... solid state automatic exposure control systems for controlling dose during ...
Breaking Medicine Technology: