Reports From the Field: Out-of-pocket expenses burden those with chronic conditions
Reports From the Field: Out-of-pocket expenses burden those with chronic conditions
People with chronic conditions spend up to five times more out-of-pocket for health care than people without chronic conditions, according to a study supported by the Partnership for Solutions project.
The Partnership for Solutions project, led by Johns Hopkins University and the Robert Wood Johnson Foundation, is an initiative to improve the care and quality of life for the more than 125 million Americans with chronic health conditions.
Coinsurance payments and gaps in health insurance coverage are the main reasons for higher out-of-pocket expenditures.
"It is no surprise that people who are sicker tend to pay more for health care, but just how much more out of their own pocket is quite significant. The magnitude of out-of-pocket expenditures is staggering," says Gerald Anderson, PhD, national program director of Partnership for Solutions and professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
The study reveals that there are significant consequences for the 108 million Americans with chronic conditions such as diabetes, heart disease, hypertension, and arthritis. Many have to pay a considerable portion of their income on medical services. Large out-of-pocket expenditures for medical services have been shown to impede access to care, affect health status and quality-of-life, and leave insufficient income for other necessities, Anderson says.
Out-of-pocket spending increased with age and varied by insurance coverage. Individuals in the oldest age category (older than 80 years) spent more than five times more out-of-pocket than persons in the youngest age category (0-19 years) and more than twice as much as those in the middle age category (45-64 years).
Out-of-pocket expenditures were highest for nonelderly persons with no insurance and for elderly persons covered only by Medicare. Both elderly and nonelderly Medicaid beneficiaries had the lowest out-of-pocket expenditures. Medications made up the largest portion of the out-of-pocket expenses.
The purpose of the study was to raise awareness of challenges faced by individuals with chronic conditions and to help policy-makers identify possible solutions. The study revealed that nonelderly individuals with chronic conditions and no health insurance were less likely to use health care, with 15% reporting never receiving health services in 1996, compared to 3% with private insurance.
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