Social Determinants of Health and Insurance Claim Denials for Preventive Care.

ABSTRACT:

Importance

The Patient Protection and Affordable Care Act (ACA) eliminated out-of-pocket cost-sharing for recommended preventive care for most privately insured patients. However, patients seeking preventive care continue to face cost-sharing and administrative hurdles, including claim denials, which may exacerbate inequitable access to care.

Objective

To determine whether patient demographics and social determinants of health are associated with denials of insurance claims for preventive care.

Design, setting, and participants

This cohort study of patients insured through their employers or the ACA Marketplaces used claims and remittance data from Symphony Health Solutions' Integrated DataVerse from 2017 to 2020; analysis was completed from January to July 2024.

E

SUBMITTER: Hoagland A 

PROVIDER: S-EPMC11411384 | biostudies-literature | 2024 Sep

REPOSITORIES: biostudies-literature