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A new Deloitte analysis reveals that women not only have more out-of-pocket medical expenses than men but also receive less coverage for every health insurance premium dollar spent.
To determine the potential financial discrepancies of health benefits, Deloitte's health actuarial team examined more than 16 million people under employer-sponsored coverage to understand the impact of benefit design on out-of-pocket financial costs for women compared to men.
They found that employed women have as much as $15.4 billion more a year than men in out-of-pocket health care expenses. For people with commercial insurance, the value of benefits for women is more than $1.3 billion less than men. The cost to employers to cover this actuarial value gap is less than $12 per employee or less than $1 a month.
These findings and more are detailed in the 12-page report titled "Hiding in plain sight — the health care gender toll," which also reveals that — based on current benefit coverage — women's out-of-pocket costs are disproportionately higher than men's for every age from 19 to 64, even when excluding pregnancy-related services.
"Our health care system has done a great job driving equity for access, from the ACA making pregnancy an essential health benefit to rules around Mental Health Parity," Andy Davis, principal for health care practice at Deloitte Consulting LLP, said in a statement. "Equity in benefits is the next challenge to address, because benefits should be designed to support every person. Women's care needs are different than men, and health care insurers and employers have an opportunity to examine and redesign benefit coverage to reduce the financial burden on women, close the benefit gap, and advance health and wellbeing for everyone."
Indeed, Deloitte's analysis validated that men and women generally consume health care differently. Overall, women seek more health care and more treatment than men (even when excluding maternity claims). Other highlights of the study:
- Women more often encounter medical services that surpass the typical deductible, leading to higher out-of-pocket payments.
- Women tend to reach their out-of-pocket maximums more frequently than men.
- On average in 2021 for all claims reviewed, women ages 19 to 64 paid 20% more than men in out-of-pocket expenditures. Removing all relevant maternity claims only closed this difference in out-of-pocket spending by less than 2%.
- Nearly half (46%) of men have less than $1,000 in claims compared to 35% for women.
Several factors were found to contribute to the difference in health care utilization patterns — including early-age recommendations for annual check-ups, greater frequency of gynecological examinations, the relatively high cost of breast cancer imaging compared to other cancer types, and the effects of menopausal transitions.
The report concludes that health insurers and employers examine and redesign benefit coverage to reduce the financial gap experienced by women and help drive health equity and optimal health and wellbeing for all people.
"Our analysis highlights a hidden financial burden on women that can not only impact their pocketbook but potentially their health," added Kulleni Gebreyes, U.S chief health equity officer and life sciences and health care sector leader for Deloitte Consulting. "Financial stressors can lead to health problems and delays in care, which can further perpetuate a cycle of preventable health care consumption, thus compounding expense. As leaders in business, health care, and society, we have an opportunity to make intentional efforts to close this gap."
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