High-deductible health plans and major cardiovascular outcomes
Early evidence shows high-deductible health plans not associated with increased risk for heart attack or stroke

Date:
July 24, 2020
Source:
Harvard Pilgrim Health Care Institute
Summary:
New research finds that individuals with cardiovascular disease
risk factors who switched to high-deductible health plans (HDHPs)
did not experience increased risk of heart attack or stroke.



FULL STORY ==========================================================================
In the first study to examine the association between high out-of-pocket
costs and adverse cardiovascular events, research led by the Harvard
Pilgrim Health Care Institute finds that individuals with cardiovascular disease risk factors who switched to high-deductible health plans (HDHPs)
did not experience increased risk of heart attack or stroke. The study, "Association Between Switching to a High-deductible Health Plan and
Major Cardiovascular Outcomes" appears in JAMA Network Open on July 24.


========================================================================== Cardiovascular disease kills more people in the U.S. than any other
condition, accounting for 30% of deaths in 2017. Improvements in
cardiovascular mortality began slowing a decade ago and major adverse cardiovascular events such as stroke and myocardial infarction began
increasing among adults under age 65.

Reasons for these trends are unclear, but experts have proposed causes
such as the earlier onset of cardiovascular risk factors, stagnation
of preventive care, and a change in health insurance coverage in the
U.S. Concerns about the contribution of health insurance to these trends
are based on the rapid expansion of HDHPs and previous research about
health effects of high out-of- pocket costs.

The study team examined the effects of a transition to a HDHP on the risk
of major adverse cardiovascular outcomes such as myocardial infarction
and stroke.

The study population, drawn from a large national health insurance plan, included individuals with risk factors for cardiovascular disease who
were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (>=$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled
in low-deductible plans. The researchers studied time to first major
adverse cardiovascular event, defined as stroke or myocardial infarction.

Study findings show that HDHP members did not experience an increase
in major adverse cardiovascular events compared with individuals
in low-deductible plans. "Based on previous high-deductible health
plan research, we had hypothesized that those with risk factors for cardiovascular disease would experience increases in major adverse cardiovascular events after a switch to high-deductible health plans,
but this did not turn out to be the case," said Frank Wharam, lead author
and Associate Professor of Population Medicine at the Harvard Pilgrim
Health Care Institute and Harvard Medical School. Dr. Wharam adds,
"HDHPs typically include features such as low or no out-of-pocket costs
for medications and preventive services. Our study detected small changes
in cardiovascular medication use and preventive services which may have protected HDHP members from increased adverse cardiovascular events.

These findings provide a measure of reassurance that HDHP enrollment
was not associated with an appreciable increased risk of major adverse cardiovascular outcomes. But researchers caution that policymakers and employers should remain careful in promoting HDHPs among low-income and
other vulnerable patients given the potential for adverse financial and
health outcomes that this study did not address. Research should also
extend follow up time to better assess long-term outcomes and should
examine whether people with HDHPs ultimately require more intensive
workups and more advanced treatments for cardiovascular events.


========================================================================== Story Source: Materials provided by
Harvard_Pilgrim_Health_Care_Institute. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. J. Frank Wharam, Jamie Wallace, Fang Zhang, Xin Xu, Christine Y. Lu,
Adrian Hernandez, Dennis Ross-Degnan, Joseph
P. Newhouse. Association Between Switching to a High-Deductible
Health Plan and Major Cardiovascular Outcomes. JAMA Network Open,
July 24, 2020; DOI: 10.1001/ jamanetworkopen.2020.8939 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200724112300.htm

--- up 1 week, 2 days, 1 hour, 54 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)