Understanding Women's Use of Out-of-Network Health Care Services and Implications for Health Care Reform
Susan Busch, Ph.D., Associate Professor, Division of Health Policy and Administration
Co-funded by the Maximilian E. & Marion O. Hoffman Foundation Inc. and the Robert Wood Johnson Foundation Clinical Scholars Program.
Women pay higher out-of-pocket costs for health care than men. One hypothesis for this disparity is that women disproportionately use out-of-network health care services, which are much more expensive than in-network services. Some women deliberately choose to use out-of-network health care providers. However, recent mainstream media reports have highlighted consumer frustration over unexpected charges from out-of-network providers who are affiliated with hospitals/emergency rooms which are in network. Women, in particular, often absorb much of these out-of-network charges as higher out-of-pocket copayments when insurers pass these costs on to consumers.
Highlighted Study Findings
In this ongoing study, Dr. Busch is conducting and using a nationally representative survey of privately insured adults, aged 18 to 64, to analyze this reported disproportionate use by women of out-of-network health care services. There are no high-quality unbiased data about this issue for women, so the study results are likely to inform policy makers as out-of-network health care reform moves forward. Dr. Busch has completed the survey and the results are about to be published.