Health plans

With high-deductible health plans, cancer patients pay more, study finds


Patients with various cancers spent much more out of their pocket than those on traditional diets. Some may delay treatment due to the higher costs.

Cancer patients on high-deductible health care plans face significantly higher out-of-pocket costs that can guide treatment decisions, according to a new study.

The study, published in Jama network open Wednesday morning examined more than 134,000 cancer patients between 2008 and 2018.

High-deductible health plans “offer less protection than traditional insurance against unexpected health expenses,” the study authors wrote.

As cancer care becomes increasingly expensive, more research should be done to examine the consequences of people delaying or dropping out of treatment due to higher enrollment in clinics. high deductible health plans.

“Overall, our results support previous studies that found cancer patients to be subject to high financial burdens that may be associated with their clinical decision making,” the authors wrote.

This study differs from previous research on health care costs in cancer patients in one important aspect, the authors said. They wrote that, to the best of their knowledge, this is the first time that researchers have used actual claims data to compare out-of-pocket expenses among a large group of cancer patients with private insurance. Previous studies have relied on cost estimates or on patients’ self-reporting of their own expenses.

Nationwide, 61% of American adults are covered by private health insurance. High deductible health plans are becoming more prevalent. Of those with private insurance, 30% had high-deductible plans in 2019, up from 4% in 2006, the authors noted.

With high deductible health plans, consumers typically pay lower premiums, but they also have to pay more in fees before the insurance company starts paying. Theoretically, high deductible health plans are supposed to inspire consumers to make better decisions about their health.

In reality, consumers benefiting from these plans delay treatment or withhold preventative measures to protect their health, such as cancer screenings, the authors wrote.

The study found that cancer patients with high deductible plans paid significantly more out of pocket than those with traditional insurance plans. The results were particularly striking in those diagnosed with breast cancer.

One year after diagnosis, breast cancer patients on high-deductible plans paid $ 1,975 out of their own pocket. Cancer patients on traditional diets paid $ 160, according to the study.

Additionally, colorectal cancer patients on high-deductible plans paid $ 865 more than those on traditional insurance plans during the month of diagnosis. People with lung cancer on high-deductible plans paid $ 655 more per month than those on traditional plans during the month of diagnosis.

The study also looked at the cost differences between cancer-free consumers. Consumers with high franchise plans paid a median of $ 63 per month in out-of-pocket expenses, while those on traditional plans paid $ 30 per month.

The researchers also compared the out-of-pocket expenses between cancer patients with high deductible plans and those without cancer in traditional insurance plans. The differences were striking: People with breast cancer paid $ 1,683 more, while patients with colorectal cancer paid $ 1,420 more out of pocket.

Those who pay more out of pocket in high-deductible plans potentially face significant financial consequences, the authors note. They refer to previous surveys indicating that a majority of Americans could not cover $ 1,000 of unexpected costs with their savings accounts.

The authors said more research should be done to examine clinical outcomes for people on high-deductible plans.

“Financially vulnerable patients and their families continue to face painful decisions about whether to undergo high-cost cancer treatment or delay or forgo care,” the authors wrote.

Researchers from Stanford University, the Department of Veterans Affairs and the Mayo Clinic performed the study.