Even Prevention Affordable Care ACT must be free by the law for millions of Americans. Do not receive recommended prevention servicesespecially Racial and ethnic minorities and other risks of patient groups.
Affordable Care Act has exempted preventive services from sharing patient costs for large chunks in the population. In other words, if you have a preventive screening test, including ACA Marketplace and have private insurance, you must have no cofpe at the time of service and will not receive the bill later. Is it easy enough?
erroneous. Our team Healthy There are economists Show it Patients spend millions of dollars every year Unexpected bills for anticipation prevention treatment. The main reason is that there is no specific regulations on which service should be exempted, for whose or how often or how often it is to decide. This omission has paid for a valuable health care cost that many people can think of free.
Now in us Recent research In the Jama Network Open Journal, we found that the burden of paying for free preventive treatment drops unbalanced to some patient groups.
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Rejection of unequal claims
Looking at the data of more than 1.5 million patients, the insurer refused to claim prevention for patients in the marginalized community. In a higher rate More than many groups.
For example, low -income patients had a 43% more chance of refusing claims than high -income patients. In addition, Asia, Hispanic and non -Heathpanic black patients were unlikely to be denied more denied than non -Hispanic white patients.
These patients not only rejected their daily benefits, but also differed significantly. For example, a patient with less experience other than high school diplomas due to this kind of claim error Nearly twice as often Than patients with college degrees. All these services must be guaranteed by the insurer.
Research on preventive treatment is as follows. In general, it is based on only claim data.In general, there is no information about patient population statistics. This limits the ability of the study to detect the difference between the patient group. However, our study uses the combination of linked claim data, remittance data that contains information on the rejection of the claim and whether the reinstatement is rejected, the self -report, the purchase transaction and the demographic data of the purchasing transaction and voter registration agency. This richer data set allowed the patient to investigate the difference in rejection based on race, ethnic, education, and income, including the reason for the treatment of treatment.
Prevention treatment is essential
A fair approach to preventive health care is simple physical, but They are also important. Prevention health care is included Main screening for cancer, cardiovascular disease and diabetes, access to contraceptives and mental health checkups. It is important for insurers to provide equal insurance applications to all patients with the cost of health care while reducing future health care costs.
Our result is a type of obstacles faced when the patient has a health checkup. It was likely that patients in prominent groups would not be guaranteed their treatment. In addition, it was more likely that the claim would be more often rejected and ultimately larger medical expenses.
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Unexpected bills can affect patients’ current health and future medical services. This obstacle can already worsen Trust in short -term health care systemsThe patient is less likely to return for subsequent screening.
Rejection of accumulated scope of patients who live with a number of alienated identities or cannot advocate themselves can further strengthen racial and socioeconomic inequality.
Fair access guarantee
Our research draws an attractive picture that other patients can face obstacles to receive preventive treatment. But more research is needed to identify how to ensure a fair approach.
When our research is only examined, we need to know how our research results are commonplace with other forms of health care. Other vulnerable patient groups (eg: Lgbtq+ patient or Patients with multiple chronic diseasesFare when you try to approach treatment.
Our team is studying how the actual bill for treatment is different for each patient group and how the patient reacts when the bill arrives. In our study 2/3 or more The rejection claims were not submitted to the insurance company, which means that many claims were not modified at the cost of the patient.
A fair policy for multiple fronts Innocent and unequal. This is a uniform application of insurers’ prevention treatment, standard claims for doctors, and a means for patients to defend themselves. This allows everyone to take the appropriate approach to health care for life.
