Chartbook on Care Affordability

Care Affordability Trends

• Few measures of Care Affordability can be tracked over time.
• One measure of Care Affordability showed worsening over time from 2002 to 2013:
  • People without a usual source of care who indicate a financial or insurance reason for not having a source of care.
• One measure of Care Affordability achieved 95% performance and was removed from the report this year:
  • People under age 65 with private insurance whose family’s out-of-pocket medical expenditures were more than 10% of total family income.
• No measures of Care Affordability improved quickly, defined as an average annual rate of change greater than 10% per year.

For more information, refer to the Introduction and Methods.

Care Affordability Measures for Which Disparities Were Eliminated

• For the measure people under age 65 whose family’s health insurance premiums and out-of-pocket medical expenses were more than 10% of total family income, disparities were eliminated for three groups:
  • Less than high school vs. at least some college.
  • Micropolitan vs. large fringe metropolitan areas.
  • Noncore vs. large fringe metropolitan areas.
• For the measure people without a usual source of care who indicate a financial or insurance reason for not having a source of care, disparities were eliminated for three groups:
  • Female vs. male.
  • Large central vs. large fringe metropolitan areas.
  • Multiple race vs. White.

Care Affordability Measures for Which Disparities Were Growing

• For the measure people without a usual source of care who indicate a financial or insurance reason for not having a source of care, disparities were growing for two groups:
  • High school vs. at least some college.
  • Uninsured vs. any private.

Care Affordability Measures for Which a New Disparity Was Identified

• For the measure people without a usual source of care who indicate a financial or insurance reason for not having a source of care, a new disparity developed between Blacks and Whites.

Measures of Care Affordability

• Depending on the data source, this chartbook tracks measures of Care Affordability through 2012 or 2013, overall and for populations defined by:
  • Age.
  • Race, ethnicity.
  • Income, education, insurance.
  • Number of chronic conditions.
• Measures of Care Affordability include:
  • Access problems due to health care costs.
  • Inefficient care due to use of services associated with more harm than benefit.

One approach to containing the growth of health care costs and thus making health care more affordable is to improve the efficiency of the health care delivery system by reducing use of unneeded services, often referred to as overuse.

As noted in the National Strategy for Quality Improvement in Health Care, “Achieving optimal results every time requires an unyielding focus on eliminating patient harms from health care, reducing waste, and applying creativity and innovation to how care is delivered.”