Transitions in health insurance among continuously insured patients with schizophrenia
Abstract Changes in health insurance coverage may disrupt access to and continuity of care, even for those who remain insured. Continuity of care is especially important in schizophrenia, which requires ongoing medical and pharmaceutical treatment. However, little is known about continuity of insura...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-02-01
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| Series: | Schizophrenia |
| Online Access: | https://doi.org/10.1038/s41537-024-00446-4 |
| _version_ | 1797274218899963904 |
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| author | Brittany L. Ranchoff Chanup Jeung John E. Zeber Gregory E. Simon Keith M. Ericson Jing Qian Kimberley H. Geissler |
| author_facet | Brittany L. Ranchoff Chanup Jeung John E. Zeber Gregory E. Simon Keith M. Ericson Jing Qian Kimberley H. Geissler |
| author_sort | Brittany L. Ranchoff |
| collection | DOAJ |
| description | Abstract Changes in health insurance coverage may disrupt access to and continuity of care, even for those who remain insured. Continuity of care is especially important in schizophrenia, which requires ongoing medical and pharmaceutical treatment. However, little is known about continuity of insurance coverage among those with schizophrenia. The objective was to examine the probability of insurance transitions for individuals with schizophrenia who were continuously insured and whether this varied across insurance types. The Massachusetts All-Payer Claims Database identified individuals with schizophrenia aged 18–64 who were continuously insured during a two-year period between 2014 and 2018. A logistic regression estimated the association of having an insurance transition – defined as having a change in insurance type – with insurance type at the start of the period, adjusting for age, sex, ZIP code in the lowest quartile of median income, and ZIP code with concentrated poverty. Overall, 15.1% had at least one insurance transition across a 24-month period. Insurance transitions were most frequent among those with plans from the Marketplace. In regression adjusted results, individuals covered by the traditional Medicaid program were 20.2 percentage points [pp] (95% confidence interval [CI]: 24.6 pp, 15.9 pp) less likely to have an insurance transition than those who were insured by a Marketplace plan. Insurance transitions among individuals with schizophrenia were common, with more than one in six people having at least one transition in insurance type during a two-year period. Given that even continuously insured individuals with schizophrenia commonly experience insurance transitions, attention to insurance transitions as a barrier to care access and continuity is warranted. |
| first_indexed | 2024-03-07T14:56:11Z |
| format | Article |
| id | doaj.art-2911bf572e554864b9f3b035711d7d76 |
| institution | Directory Open Access Journal |
| issn | 2754-6993 |
| language | English |
| last_indexed | 2024-03-07T14:56:11Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Schizophrenia |
| spelling | doaj.art-2911bf572e554864b9f3b035711d7d762024-03-05T19:25:21ZengNature PortfolioSchizophrenia2754-69932024-02-011011810.1038/s41537-024-00446-4Transitions in health insurance among continuously insured patients with schizophreniaBrittany L. Ranchoff0Chanup Jeung1John E. Zeber2Gregory E. Simon3Keith M. Ericson4Jing Qian5Kimberley H. Geissler6School of Public Health and Health Sciences, University of Massachusetts AmherstSchool of Public Health, State University of New York at AlbanySchool of Public Health and Health Sciences, University of Massachusetts AmherstKaiser Permanente Washington Health Research InstituteNational Bureau for Economic ResearchSchool of Public Health and Health Sciences, University of Massachusetts AmherstDepartment of Healthcare Delivery and Population Sciences, UMass Chan Medical School-BaystateAbstract Changes in health insurance coverage may disrupt access to and continuity of care, even for those who remain insured. Continuity of care is especially important in schizophrenia, which requires ongoing medical and pharmaceutical treatment. However, little is known about continuity of insurance coverage among those with schizophrenia. The objective was to examine the probability of insurance transitions for individuals with schizophrenia who were continuously insured and whether this varied across insurance types. The Massachusetts All-Payer Claims Database identified individuals with schizophrenia aged 18–64 who were continuously insured during a two-year period between 2014 and 2018. A logistic regression estimated the association of having an insurance transition – defined as having a change in insurance type – with insurance type at the start of the period, adjusting for age, sex, ZIP code in the lowest quartile of median income, and ZIP code with concentrated poverty. Overall, 15.1% had at least one insurance transition across a 24-month period. Insurance transitions were most frequent among those with plans from the Marketplace. In regression adjusted results, individuals covered by the traditional Medicaid program were 20.2 percentage points [pp] (95% confidence interval [CI]: 24.6 pp, 15.9 pp) less likely to have an insurance transition than those who were insured by a Marketplace plan. Insurance transitions among individuals with schizophrenia were common, with more than one in six people having at least one transition in insurance type during a two-year period. Given that even continuously insured individuals with schizophrenia commonly experience insurance transitions, attention to insurance transitions as a barrier to care access and continuity is warranted.https://doi.org/10.1038/s41537-024-00446-4 |
| spellingShingle | Brittany L. Ranchoff Chanup Jeung John E. Zeber Gregory E. Simon Keith M. Ericson Jing Qian Kimberley H. Geissler Transitions in health insurance among continuously insured patients with schizophrenia Schizophrenia |
| title | Transitions in health insurance among continuously insured patients with schizophrenia |
| title_full | Transitions in health insurance among continuously insured patients with schizophrenia |
| title_fullStr | Transitions in health insurance among continuously insured patients with schizophrenia |
| title_full_unstemmed | Transitions in health insurance among continuously insured patients with schizophrenia |
| title_short | Transitions in health insurance among continuously insured patients with schizophrenia |
| title_sort | transitions in health insurance among continuously insured patients with schizophrenia |
| url | https://doi.org/10.1038/s41537-024-00446-4 |
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