High-deductible health plans may be harmful for patients with COPD

(HealthDay)—For patients with chronic obstructive pulmonary disease (COPD), high-deductible health plans (HDHPs) are associated with increased likelihood of reporting foregoing care because of costs and cost-related nonadherence, according to a study presented at the American Thoracic Society 2019 International Conference, held from May 17 to 22 in Dallas.

Adam W. Gaffney, M.D., from Harvard Medical School in Boston, and colleagues analyzed data from the 2011 to 2017 National Health Interview Survey for privately-insured adults aged 40 to 64 years with COPD, based on self-reported diagnoses of chronic bronchitis, COPD, and/or emphysema. Patients covered by HDHPs (849 patients) were compared with those with a low or no deductible (traditional) private plan (1,404 patients).

The researchers found that individuals with HDHPs were more likely to be white and slightly more likely to have only a high school degree. Compared with those in a traditional plan, individuals with HDHPs were significantly more likely to report foregoing care because of costs (15.0 versus 6.9 percent), a medical bill problem (77.0 versus 62.3 percent), any cost-related medication nonadherence (28.8 versus 19.1 percent), one or more emergency room visits in the last year (31.9 versus 26.4 percent), and one or more hospitalizations (15.9 versus 12.0 percent) in unadjusted analyses. Similar findings were observed in fully-adjusted models.

"High-deductible plans may have harmful consequences in patients with COPD, including greater financial stress, reduced health care access, and worse outcomes," the authors write.

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