Women pay $15.4 billion more out of pocket for medical expenses
For people with commercial insurance, the value of benefits for women is more than $1.3 billion less than men.
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Employed women have as much as $15.4 billion more a year than men in out-of-pocket healthcare expenses, despite largely buying the same health insurance products, according to new findings published this week by Deloitte.
To understand the potential financial discrepancies of health benefits, Deloitte's health actuarial team examined more than 16 million people under employer-sponsored coverage to determine the impact of benefit design on out-of-pocket financial costs for women compared to men.
The report, "Hiding in Plain Sight – The Health Care Gender Toll," revealed 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.
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.
WHAT'S THE IMPACT
Deloitte's analysis confirmed that men and women generally consume healthcare differently. Overall, women seek more healthcare and more treatment than men, and this utilization difference holds true even when excluding maternity claims.
Yet the analysis found that while women experience 10% more in total health expenditures relative to men, it did not explain why out-of-pocket expenditures for women are 18% higher.
It found that women more often encounter medical services that surpass the typical deductible, leading to higher out-of-pocket payments. They also tend to reach their out-of-pocket maximums more frequently than men.
On average in 2021 for all claims reviewed, women aged 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 spend by less than 2%. Forty-six percent of men have less than $1,000 in claims compared to 35% for women.
Several factors were found to contribute to the difference in healthcare 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, among various others.
The $15.4 billion burden on women was not the result of maternity claims. The findings indicated the actuarial value of benefits – the ratio of average coverage provided by the insurance carrier for the population – was lower for women compared to men in aggregate. This held true whether maternity claims were included or excluded from the analysis.
Notably, the benefits were consistently lower for women across all age groups except for the ages between 30 and 51. This age range corresponds to the latter portion of women's childbearing years, perimenopause and menopause. As women are hitting their deductibles more frequently during these stages of life, it's expected that their actuarial values would be higher. Nevertheless, beyond these years, a trend emerges when observing women's lifespans in their entirety – women consistently derive lesser value for each healthcare premium dollar spent.
THE LARGER TREND
Based on this analysis, Deloitte recommends an intentional review of benefit design coverage with a focused analysis of the impact on men, women and individuals of any gender.
Employers possess the ability to close this $15.4 billion expenditure gap – at the approximate cost of $133 per enrolled employee annually – potentially creating financial equity in their healthcare benefit, Deloitte found.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
