14% of Chronically Ill Patients Buy Too Much Insurance, Driving Up Costs

Jennifer Thew, RN, March 17, 2017

Many chronically ill patients who would benefit from a medium-coverage health insurance plan and preventative care are instead choosing comprehensive insurance plans, researchers say.

14% of Chronically Ill Patients Buy Too Much Insurance, Driving Up Costs
Jian Ni, PhD

Many patients with chronic illness are choosing a pound of cure over an ounce of prevention and driving up medical costs in the process, according to findings in a study examining health insurance choices as they correlate to costs.

"Our results indicate that there exists a sizable segment of consumers who purchase more comprehensive plans than needed because of high uncertainty vis-à-vis their health status, and that once in the plan, they opt for curative care even when their illness could be managed through preventive care," the study says.

When Evidence Says No, But Doctors Say Yes

Chronic medical conditions such as heart disease, cancer, hypertension, respiratory diseases, diabetes, Alzheimer's disease, and kidney disease account for 75% of healthcare expenditures in the United States.

Individuals with chronic diseases can consume three types of healthcare services:

  1. Secondary preventive care, which includes diagnostic tests
  2. Primary preventive care, which includes drugs that help prevent progression of a disease
  3. Curative care, which includes surgeries and expensive drugs that boost a patient's health

After analyzing three years of data from a health insurer that offered basic, medium, and comprehensive coverage Preferred Provider Organization plans to customers through their employers, researchers found that of the 3,000 people whose data was analyzed, about 14% would have been good matches for a medium coverage plan and preventive care, but they elected the more costly comprehensive plans and curative care instead.

Jennifer Thew, RN

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders Media.

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