Health savings plans and disparities in access to care by race and ethnicity
This article was originally published here
Am J Prev Med. May 10, 2021: S0749-3797 (21) 00185-9. doi: 10.1016 / j.amepre.2021.02.020. Online before printing.
INTRODUCTION: High deductible health plans are often touted to motivate patients to become informed health care buyers; however, racial / ethnic minorities report that high deductibles prevent them from seeking necessary care. One suggested way to ease the financial burden of high deductible health plans is through the use of health savings plans. This cross-sectional study examines whether blacks and Hispanics with chronic conditions enrolled in high-deductible health plans experience greater access to care challenges than non-Hispanic whites and whether racial / ethnic disparities are alleviated through use health savings plans.
Methods: Weighted linear, multivariate probability regression models were estimated (analyzes were conducted in December 2020), adjusting for individual attributes and contextual factors that may explain variation in access to health care. Chronically ill black, Hispanic, and white adults who were born in the United States and enrolled in a high-deductible health plan from the National Health Survey in 2011-2018 were included. Associations were tested among 3 independent variables – being black, being Hispanic, and health savings plan use (and their interaction) – and access to health care outcomes of interest, including access related to affordability, access to providers and delayed care.
RESULTS: Blacks and Hispanics were less likely to use health savings plans, and blacks were more likely to have problems accessing health care. Although the use of health savings plans has had minimal effect in reducing racial / ethnic disparities in access related to affordability, health savings plans have also been shown to exacerbate the problems. racial / ethnic disparities in access to health care providers.
CONCLUSIONS: Understanding how health savings schemes work to improve access to care among racial / ethnic minorities can help inform policy approaches related to their use.