More health coverage could mean greater diagnosis, control of chronic conditions

Though individuals with chronic conditions often are costly to insure, having health insurance appears to improve such patients' health and increase diagnosis of their conditions, a new study suggests.

In an article summarizing their findings in this month's issue of Health Affairs, the study authors estimate that there would be 1.5 million more people diagnosed with one or more of a select group of chronic conditions and 659,000 fewer uncontrolled cases among these individuals if the number of nonelderly uninsured Americans were cut in half.

These findings echo a March study that found Medicaid expansion has led to an increase in diabetes diagnoses.

Researchers also found a correlation between insurance coverage and better disease management among individuals already diagnosed with certain chronic conditions. For example, insured patients had lower total cholesterol, lower hemoglobin A1c (blood sugar) and lower systolic blood pressure than their uninsured counterparts.

One motivation for conducting such a study was that so much recent research concerned the financial implications of insurance coverage expansion rather than its effects on health, lead study author Joshua Salomon, a professor of global health at the Harvard T.H. Chan School of Public Health, tells the Washington Post's Wonkblog. "That always struck us as peculiar," he adds.

The findings suggest that the Affordable Care Act "could have significant effects on chronic disease identification and management," Salomon and his fellow study authors write. However, they caution that policymakers should carefully weigh how increased insurance coverage for chronically ill individuals will affect care demand and costs.

Indeed, some health insurers have requested--and in some cases have been granted--steep rate increases for 2016 exchange plans due in part to higher costs associated with newly insured members with chronic conditions. And a similar situation will likely spur Highmark to offer more narrow-network plans, FierceHealthPayer has reported.

To learn more:
- here's the study (subscription required)
- read the Wonkblog post

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