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Some of the preventive services that are "free" for U.S. patients with employer health plan coverage cost the employers and their insurers plenty.
Seven of the 130 services included in the current Affordable Care Act preventive services package typically cost an employer's self-insured health plan or a group health insurance provider more than $1,000 per patient, according to a Health Care Cost Institute analysis of 2022 employer plan claim data.
The two most expensive items in the package are related to HIV.
In 2022, providing an injection that protects a patient against being infected by HIV cost an average of $3,898, and the antiviral drugs used to keep HIV infections from causing full-blown AIDS cost $1,926, HCCI reported.
A third anti-HIV item, the oral version of nucleoside and nucleotide reverse transcriptase inhibitors, cost $1,241.
Three of the items on the list were related to colonoscopies, or efforts to detect and prevent colon cancer, with a price range of $1,269to $1,538.
The seventh item on the list, which cost $1,181, is the Mirena IUD contraceptive system.
The cheapest item on the list, an automated red blood cell count, cost just $3, and several procedures used to detect anemia in pregnant women cost $4.
Detecting anemia can help prevent women from bleeding to death during childbirth.
The median cost of the items included in the HCCI analysis was $26.50.
Health Care Cost Institute: The Health Care Cost Institute is a nonprofit organization that helps insurers and employer health plan administrators share employer plan cost data with researchers.
Affordable Care Act preventive services package: The Affordable Care Act requires major medical plans — including employer-sponsored plans created or changed since the preventive services coverage rules took effect — to cover the services and products in the standard preventive services package without imposing deductibles, co-payments or other cost-sharing requirements on the patients.
In theory, the services included in the preventive services package are supposed to pay for their keep by dramatically improving the quality of care or by holding down the overall cost of care.
For payers and others, one challenge has been finding ways to measure the impact of preventive services procedures that may have little or no effect on people's health in the short run but may have a big effect on their health later in their lives.
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