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Portfolio > Economy & Markets > Fixed Income

Underinsurance may drive up hospital costs

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Analysts have found evidence insured consumers who have too much “skin in the game” may be more likely to end up in the hospital.

Sara Collins and other analysts at the Commonwealth Fund have reported that find in a summary of results from a 2014 telephone survey of about 6,000 adults ages 19 and older living in the continental United States. The Commonwealth Fund has also sponsored similar surveys in the past.

See also: Ranks Of The Underinsured Are Growing Too, Report Shows

The analysts classified participants as underinsured if the participants had major medical coverage throughout the year but had deductibles exceeding 5 percent of income; had plan out-of-pocket medical expenses exceeding 10 percent of income; or had an income under 200 percent of the federal poverty level and out-of-pocket expenses exceeding 5 percent of income.

When the analysts looked at underinsured participants who had chronic conditions such as asthma, high blood pressure or diabetes, they found that 14 percent had gone to the emergency room or stayed in a hospital overnight as a result of the condition in the past year.

About 19 percent of the uninsured participants with chronic conditions had gone to the hospital because of the condition. Only 8 percent of the well-insured participants had gone to the hospital because of their conditions.

See also: ‘Smart spending’ backers keep talking

The percentage of all insured participants ages 19 to 64 that the analysts classified as underinsured stood at 23 percent in 2014. That was the same as in 2012 and up from 12 percent in 2003.

The total underinsured rate fell to 37 percent in 2014, from 45 percent, for people with individual coverage, and it fell to 22 percent, from 31 percent, for people with Medicaid.

The underinsured rate for people with group coverage held steady at 20 percent.

The percentage with deductibles exceeding 5 percent of income increased to 11 percent in 2014, from 8 percent in 2012.

The share of individual coverage holders with high deductible-to-income ratios fell to 24 percent, from 30 percent.

The share with high-deductible group coverage from employers with fewer than 100 employees increased to 20 percent, from 14 percent.

The share with high-deductible group coverage from bigger employers increased to 8 percent, from 6 percent.


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