Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Asthma is a long-term health problem that affects 6.8 million children and 18.7 million adults in the United States. Patients can take medicine to control their asthma. But many patients don’t take their medicine every day. One reason may be that patients have trouble paying for it.
Insurance plans help patients pay for health care and medicine. In regular insurance plans, patients spend some of their own money, called out-of-pocket costs, before insurance pays. For example, patients may need to spend $500 on healthcare services or medicine before the insurance plan starts to pay for their health care.
Many employers are now changing their insurance plans for employees to high-deductible health plans, or HDHPs. In an HDHP, patients or families pay a smaller amount each month to have insurance but must pay higher out-of-pocket costs, such as $1,000 to $2,000, before insurance begins to cover their healthcare costs. Patients with high out-of-pocket costs sometimes choose not to buy the medicine they need. But some insurance plans have a list of medicines that are free to patients and families because they help prevent health problems. Asthma medicine is usually on this list.
In this study, the research team is comparing whether switching from regular insurance to an HDHP changes how often people use asthma medicine or go to the hospital because of asthma. The team also wants to know whether these results differ if the HDHP includes a list of free medicines, including asthma medicine.
Who can this research help?
Employers can use results of this study when considering types of insurance to offer to their employees. Patients with long-term health problems can use results when considering what types of insurance to choose.
What is the research team doing?
The research team is using health insurance data from more than 2 million patients with asthma who have insurance through their employers. The team is looking at patients who switch from a regular insurance plan to an HDHP. The research team is also comparing HDHPs that have lists of free medicine with those that don’t. For each type of insurance, the team is comparing asthma medicine use, visits to the emergency room, and hospital stays for asthma-related causes. In addition, the team is comparing the amount of money patients spend on healthcare costs before and after switching insurance plans.
Adults with asthma and parents of children with asthma are working with the research team to plan and conduct the study.
Research methods at a glance
| Design Elements | Description |
|---|---|
| Design | Observational: cohort study |
| Population | Adults and children with asthma enrolled in an employer-sponsored health plan from a large national insurance carrier for 24 months continuous from 2004 to 2017 |
| Interventions/ Comparators |
|
| Outcomes |
Primary: proportion of days covered, medicine discontinuation rate, use of asthma rescue medicine, asthma-related ER visits and hospital stays, out-of-pocket costs |
| At least 1-year follow-up for primary outcomes |
COVID-19-Related Study
Summary
During the COVID-19 pandemic, many people have lost jobs and their job-related health insurance. With this enhancement, the research team will look at how loss of insurance affects adults and children with asthma.
The team will test an online chatbox for asthma care. The team wants to learn whether use of the chat box helps people find alternate health insurance and self-manage their asthma. They will look at how it improves health insurance coverage and health outcomes for asthma.
Enhancement Award Amount: $497,998