Cost Conversations Between Primary Care Providers and Patients with Expanded Medicaid Coverage

Excerpt

Patients face increasing out-of-pocket (OOP) costs for healthcare,¹ which have been associated with medication non-adherence and poor health outcomes.^{2, 3} While low-income patients may frequently have concerns about OOP costs—even if they have insurance with generous covered benefits—they may not raise cost concerns with physicians. Little is known about cost conversations between primary care providers (PCPs) and low-income patients. Our objective was to determine the frequency, predictors, and PCPs’ perceptions of the impact of cost conversations with low-income patients in an expanded Medicaid program in Michigan (“Healthy Michigan Plan” [HMP]), a state program for adults ages 19–64 with incomes ≤ 138% of the federal poverty level (FPL) and includes limited cost-sharing for beneficiaries (≤ 2% of income). …