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Association Between Patient Cost Sharing and Cardiac Rehabilitation Adherence

Michel Farah1, Maya Abdallah1, Heidi Szalai2

  • 1Department of Internal Medicine, University of Massachusetts Medical School - Baystate, Springfield.

Mayo Clinic Proceedings
|December 7, 2019
PubMed

Insights

Patient cost sharing significantly reduces cardiac rehabilitation (CR) attendance. Higher co-pays and deductibles are linked to fewer CR sessions, highlighting the need for policy reevaluation.

Area of Science:

  • Cardiology
  • Health Economics
  • Public Health

Background:

  • Cardiac rehabilitation (CR) is a vital, yet underutilized, program for cardiovascular disease recovery.
  • Patient adherence to CR is crucial for optimal outcomes.
  • Cost-sharing policies, including co-pays and deductibles, may impact patient engagement in healthcare services.

Purpose of the Study:

  • To investigate the association between patient cost-sharing obligations and adherence to cardiac rehabilitation programs.
  • To determine if household income influences the relationship between cost sharing and CR attendance.

Main Methods:

  • A retrospective analysis of 603 patients enrolled in CR was conducted.
  • Detailed cost-sharing data (co-pays, deductibles) were collected.
  • The number of CR sessions attended was evaluated against cost-sharing variables and household income.

Main Results:

  • 39% of patients faced some form of cost sharing.
  • Any cost sharing was associated with 6 fewer CR sessions.
  • A dose-response relationship was observed: higher co-pays correlated with significantly lower CR attendance (1.5 fewer sessions per $10 increase).
  • Patients with deductibles renewing in January attended fewer sessions if hospitalized late in the year.

Conclusions:

  • Cost sharing presents a significant barrier to cardiac rehabilitation adherence.
  • A clear dose-response relationship exists, where increased financial burden leads to decreased participation.
  • Payers and insurance companies should reconsider cost-sharing policies for CR to improve access and utilization.
Abstract

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