Role of Chronic Conditions in Out-of-Pocket Costs for Preventive Care in the US

Are patients with chronic conditions equally protected from out-of-pocket (OOP) costs for preventive care under the cost-sharing exemptions mandated by the Patient Protection and Affordable Care Act’s (ACA)?In this propensity score–matched cohort study of more than 1 million privately insured US patients, those with ambulatory care–sensitive conditions had a 19.20% higher likelihood of cost-sharing for preventive services and 20.69% greater expected OOP spending compared with patients without any chronic conditions.Patients with chronic conditions faced increased preventive care costs, implying that improved compliance with ACA cost-sharing exemptions may reduce financial burdens and disparities in preventive care access.

Corresponding Author: Alex Hoagland, PhD, Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College St, Ste 440, Toronto, ON M5T 3M6, Canada (alexander.hoagland@utoronto.ca).

Link to the article in your story

We encourage you to link out to this article in your story using the link below. It includes an access token that will give free access to the article for your readers up to one year after publication. (The link will be live after the article publishes and embargo is lifted.)

Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Need more information? Contact us.