Cancer survivors enrolled in high deductible health plans may delay or forgo cancer follow-up care, according to a study published in Journal of Oncology Practice. “HDHP enrollment may serve as a barrier to access to care among cancer survivors,” according to the authors, although they noted that involvement in a health savings account (HSA) could mitigate this affect.
Researchers assessed National Health Interview Survey data from 2010 to 2017 to identify privately insured adults aged 18 to 64 years; the cohort included 4,321 cancer survivors and 95,316 individuals without a history of cancer. Only one-third of patients with high deductible plans also had HSAs.
High deductibles are a barrier to care
Among cancer survivors, enrollment in a high deductible health plan with (8.9%) or without (13.9%) an HSA was associated with more delayed/forgone care compared with those enrolled in low-deductible health plans (7.9%; P<0.05). However, HSA enrollment was associated with less delayed or forgone care among high-deductible health plan cancer survivors (P<0.05).
There was a small difference in emergency department (ED) visits between those with a high deductible health plan without an HSA (15.3%) and those with low deductible health plans (14.1%; P<0.05) or those with high deductible health plans with an HSA (13.4%; P<0.05) among individuals without a history of cancer.
“Improvement to care coordination efforts may be needed to reduce ED visits among privately insured cancer survivors,” the researchers concluded.
