Research from Harvard Medical School and Harvard Pilgrim Health Care Institute Provides New Study Findings on Microvascular Disease (Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment): Microvascular Disease

2022 MAY 19 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Investigators publish new report on microvascular disease. According to news reporting from Boston, Massachusetts, by NewsRx journalists, research stated, “The Affordable Care Act mandates that primary preventive services have no out-of-pocket costs but does not exempt secondary prevention from out-of-pocket costs. Most commercially insured patients with diabetes have high-deductible health plans (HDHPs) that subject key microvascular disease-related services to high out-of-pocket costs.”

The news editors obtained a quote from the research from Harvard Medical School and Harvard Pilgrim Health Care Institute: “Brief treatment delays can significantly worsen microvascular disease outcomes. RESEARCH AND This cohort study used a large national commercial (and Medicare Advantage) health insurance claims data set to examine matched groups before and after an insurance design change. The study group included 50,790 patients with diabetes who were continuously enrolled in low-deductible ( $500) health plans during a baseline year, followed by up to 4 years in high-deductible ( $1,000) plans after an employer-mandated switch. HDHPs had low out-of-pocket costs for nephropathy screening but not retinopathy screening. A matched control group included 335,178 patients with diabetes who were contemporaneously enrolled in low-deductible plans. Measures included time to first detected microvascular disease screening, severe microvascular disease diagnosis, vision loss diagnosis/treatment, and renal function loss diagnosis/treatment. HDHP enrollment was associated with relative delays in retinopathy screening (0.7 months [95% CI 0.4, 1.0]), severe retinopathy diagnosis (2.9 months [0.5, 5.3]), and vision loss diagnosis/treatment (3.8 months [1.2, 6.3]). Nephropathy-associated measures did not change to a statistically significant degree among HDHP members relative to control subjects at follow-up.”

According to the news editors, the research concluded: “People with diabetes in HDHPs experienced delayed retinopathy diagnosis and vision loss diagnosis/treatment of up to 3.8 months compared with low-deductible plan enrollees. Findings raise concerns about visual health among HDHP members and call attention to discrepancies in Affordable Care Act cost sharing exemptions.”

For more information on this research see: Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment. Diabetes Care, 2021. The publisher for Diabetes Care is American Diabetes Association.

A free version of this journal article is available at https://doi.org/10.2337/dc21-0407.

Our news journalists report that additional information may be obtained by contacting J. Frank Wharam, Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States. Additional authors for this research include Jamie Wallace, Stephanie Argetsinger, Fang Zhang, Christine Y. Lu, Tomasz P. Stryjewski, Dennis Ross-Degnan, Joseph P. Newhouse.

ORCID is an identifier for authors and includes bibliographic information. The following is ORCID information for the author of this research: J. Frank Wharam (http://orcid.org/0000-0003-2053-0757).

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