The potential cumulative financial hit to patients with costly chronic illnesses is considerable. Those with high spending in at least 5 of the 6 years examined had average annual expenses around $30 000. That’s well above typical deductible levels for employer-sponsored plans (usually below $2000) or for Affordable Care Act (ACA) plans (usually in the $1500-$4000 range for silver-rated plans). Unsurprisingly, certain chronic conditions—like rheumatologic conditions, renal disease, diabetes, and AIDS—are associated with high, long-term spending persistence. […]
Patients with high health care costs, particularly those with chronic conditions, are increasingly left underinsured today. A new Medicare initiative could begin to change that. It would permit Medicare Advantage plans in 7 states to reduce cost sharing for proven, high-value therapies targeted to patients with chronic conditions.
More details in my latest post on the JAMA Forum.