Health Care Costs and Financing

Changing health insurance plans might adversely affect a person's care as well as increase care costs during the first year

Recent economic pressures in the health insurance market have resulted in cycles of increased costs, reduced benefits, and consumer dissatisfaction. This, in turn, has led to more frequent changes in health insurance. However, changing insurance plans may have an adverse effect on a person's care and increase the costs associated with care during the first year, concludes a study supported by the Agency for Healthcare Research and Quality (HS09963).

Peter Franks, M.D., of the University of California, Davis, and his colleagues used 1996-1999 claims data on 335,547 adult patients from a managed care organization in Rochester, NY, to examine the relationship between the first year of health insurance and receipt of Pap tests, receipt of mammograms in women older than 40, physician use, avoidable hospitalizations, and care expenditures.

After adjustment for factors such as age, case mix, and socioeconomic status, the first year of insurance was associated with a higher risk of not getting a mammogram, a higher risk of avoidable hospitalization, greater likelihood of visiting a physician, and higher expenditures, especially for testing. There was no relationship, however, between Pap test compliance and year of enrollment. Together with studies showing decreased patient satisfaction with forced health plan switches, these findings suggest that there may be pervasive adverse consequences of the frequent rebidding of insurance contracts by employers.

See "On being new to an insurance plan: Health care use associated with the first years in a health insurance plan," by Dr. Franks, Colin Cameron, Ph.D., and Klea D. Bertakis, M.D., in the September 2003 Annals of Family Medicine 1(3), pp. 156-161.

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