TABLE 3.
Out-of-Pocket Spending Per 30 Days Among Patients in FIHPs and SFHPs Before and After Parity
| FIHPs | SFHPs | Unadjusted DD | Adjusted DD | |||||
|---|---|---|---|---|---|---|---|---|
| Before parity | After parity | Before parity | After parity | DD | 95% CI | aDDa | 95% CIa | |
| Overall, N | 480 | 198 | 688 | 521 | – | – | – | – |
| Mean (SD) | $132 ($346) | $241 ($777) | $108 ($241) | $173 ($369) | $44 | −$34-$123 | $34 | −$38-$106 |
| 25th percentile | $18 | $5 | $24 | $19 | −$8 | −$18-$1 | −$4 | −$15-$6 |
| 50th percentile | $33 | $38 | $38 | $53 | −$11 | −$21-$0 | −$6 | −$16-$4 |
| 75th percentile | $63 | $112 | $85 | $112 | $21 | −$9-$52 | $27 | −$5-$58 |
| 90th percentile | $298 | $571 | $204 | $505 | −$23 | −$355-$308 | −$105 | −$424-$215 |
| 95th percentile | $809 | $945 | $492 | $948 | −$319 | −$953-$316 | −$204 | −$833-$425 |
| $0 | 15.6% | 23.2% | 1.3% | 13.4% | 0.609 | 0.498-0.752 | 0.662 | 0.535-0.820 |
| ≥ $100 | 16.9% | 27.8% | 20.1% | 30.5% | 1.020 | 0.909-1.149 | 1.064 | 0.943-1.190 |
| States with limit, n | 204 | 53 | 350 | 110 | – | – | – | – |
| Mean (SD) | $141 ($324) | $131 ($239) | $112 ($235) | $224 ($412) | −$123 | −$234-−$12 | −$86 | −$198-$26 |
| 25th percentile | $22 | $28 | $23 | $28 | $1 | −$14-$16 | $8 | −$5-$22 |
| 50th percentile | $33 | $50 | $34 | $72 | −$19 | −$50-$12 | −$13 | −$46-$20 |
| 75th percentile | $66 | $103 | $72 | $156 | −$44 | −$165-$77 | $0 | −$102-$103 |
| 90th percentile | $423 | $296 | $251 | $545 | −$421 | −$1,026-$183 | −$275 | −$839-$290 |
| 95th percentile | $890 | $485 | $605 | $1,162 | −$962 | −$2,219-$294 | −$780 | −$2,268-$707 |
| $0 | 8.8% | 3.8% | 0.9% | 2.7% | 0.595 | 0.342-1.031 | 0.602 | 0.346-1.053 |
| ≥ $100 | 20.1% | 28.3% | 19.4% | 40.0% | 0.870 | 0.704-1.064 | 0.935 | 0.746-1.163 |
| States without limit, n | 276 | 145 | 338 | 411 | – | – | – | – |
| Mean (SD) | $125 ($348) | $282 ($894) | $104 ($247) | $160 ($357) | $101 | −$6-$209 | $71 | −$25-$167 |
| 25th percentile | $15 | $0 | $26 | $15 | −$3 | −$14-$8 | −$7 | −$17-$2 |
| 50th percentile | $34 | $33 | $50 | $50 | −$1 | −$14-$13 | −$1 | −$15-$13 |
| 75th percentile | $63 | $114 | $91 | $108 | $34 | −$2-$70 | $35 | −$1-$71 |
| 90th percentile | $264 | $668 | $164 | $463 | $105 | −$281-$492 | $124 | −$314-$561 |
| 95th percentile | $686 | $1,049 | $408 | $929 | −$158 | −$1,011-$694 | $150 | −$528-$828 |
| $0 | 20.7% | 30.3% | 1.8% | 16.3% | 0.629 | 0.493-0.800 | 0.654 | 0.508-0.848 |
| ≥ $100 | 14.5% | 27.6% | 20.7% | 28.0% | 1.111 | 0.952-1.282 | 1.124 | 0.971-1.299 |
Notes: Linear regression was used for estimating mean OOP spending. Logistic regression was used to estimate the probability of paying a 30-day standardized OOP cost of $0, as well as paying more than $100.
aBolded values denote statistical significance of the interaction term with P <0.05.
aDD = adjusted difference-in-differences; DD = difference-in-differences; FIHP = fully insured health plan; OOP = out-of-pocket; SFHP = self-funded health plan.