Kaiser Permanente Northern California Division of Research, Oakland, California, USA.
Health Aff (Millwood). 2012 Dec;31(12):2641-8. doi: 10.1377/hlthaff.2012.0059.
Consumer-directed health plans are plans with high deductibles that typically require patients to bear no out-of-pocket costs for preventive care, such as annual physicals or screening tests, in order to ease financial barriers and encourage patients to seek such care. We surveyed people in California who had a consumer-directed health plan and found that fewer than one in five understood that their plan exempted preventive office visits, medical tests, and screenings from their deductible, meaning that this care was free or had a modest copayment. Roughly one in five said that they had delayed or avoided a preventive office visit, test, or screening because of cost. Those who were confused about the exemption were significantly more likely to report avoiding preventive visits because of cost concerns. Special efforts to educate consumers about preventive care cost-sharing exemptions may be necessary as more health plans, including Medicare, adopt this model.
消费者导向型健康计划是指具有高免赔额的计划,通常要求患者在进行预防性护理(如年度体检或筛查测试)时无需自付任何费用,以减轻经济障碍并鼓励患者寻求此类护理。我们对加利福尼亚州的消费者导向型健康计划参保人进行了调查,发现只有不到五分之一的人知道他们的计划豁免了预防性就诊、医疗检查和筛查的免赔额,这意味着这些护理是免费的或只需支付适度的共付额。大约五分之一的人表示,由于费用问题,他们推迟或避免了预防性就诊、检查或筛查。那些对豁免规定感到困惑的人更有可能因为费用问题而避免进行预防性就诊。随着越来越多的健康计划(包括医疗保险)采用这种模式,可能需要特别努力教育消费者了解预防性护理费用分担豁免的相关内容。