financial wellness
Preventive care is free by law, but many Americans get incorrectly billed − especially if you’re poor, a person of color or don’t have a college degree
Preventive care costs exacerbate health disparities, disproportionately affecting marginalized communities. Insurance claim denials are higher for minority and low-income patients despite legal exemptions.
Alex Hoagland, University of Toronto and Michal Horný, UMass Amherst
Even though preventive care is supposed to be free by law for millions of Americans thanks to the Affordable Care Act, many don’t receive recommended preventive services, especially racial and ethnic minorities and other at-risk patient groups.
The Affordable Care Act exempted preventive services from patient cost-sharing for large chunks of the population. This means that if you receive preventive screening and have private insurance, including through the ACA Marketplace, there should be no copay at time of service, and you shouldn’t get a bill later on. Easy enough, right?
Wrong. Our team of health economists has shown that patients spend millions of dollars every year on unexpected bills for preventive care. The main reason for this is that no specific regulations were put in place to determine exactly which services should be exempted, or for whom, or how often. This omission has left many people on the hook to pay for valuable health care they thought would be free.
Now, in our recently published research in the journal JAMA Network Open, we’ve found that the burden of paying for what should be free preventive care disproportionately falls on some patient groups.
Inequitable claim denials
Looking at data from over 1.5 million patients, our study demonstrates that insurers deny preventive claims for patients from marginalized communities at higher rates than for those from majority groups.
For example, low-income patients were 43% more likely than high-income patients to have their claims denied. In addition, Asian, Hispanic and non-Hispanic Black patients were each roughly twice as likely as non-Hispanic white patients to have claims denied.
Not only were these patients denied routine benefits, but they also saw large differences in rates of billing errors. For example, patients with a high school diploma or less experienced denials due to this kind of billing error almost twice as often than patients with college degrees. All of these services should have been covered by an insurer.
Research on preventive care access is commonly based only on claims data, which doesn’t typically have information on patient demographics. This limits a study’s ability to detect differences across patient groups. Our study, however, uses a combination of linked claims data, remittance data containing information on why claims were denied and whether they were resubmitted, and demographic data from self-reports, purchase transactions and voter registries. Together, this richer dataset allowed us to examine differences in denials based on race and ethnicity, education and income, including reasons why patients were denied care.
Preventive care is essential
Equitable access to preventive health care is about more than just physicals, although those are important, too. Preventive health care includes key screenings for cancers, cardiovascular disease and diabetes, access to contraceptives, and mental health checkups, among other services. Ensuring that insurers provide equal coverage for these services for all patients is important to improve health outcomes and quality of life for everyone while reducing future health care costs.
Our results paint a picture of the kinds of hurdles patients face when they seek health screenings. Patients from underrepresented groups were not only more likely to be told their care wouldn’t be covered. They were also more likely to have their claims processed incorrectly, leading to more frequent denials and, ultimately, larger medical bills. https://www.youtube.com/embed/Uc2uG6LhFQQ?wmode=transparent&start=0 Few patients appeal claim denials, even though rejections may be unjustified.
Unexpected bills can affect both a patient’s current health and their future use of health care services. These hurdles can exacerbate an already tenuous trust in a fragmented health care system, making patients less likely to return for follow-up screenings.
Stacked coverage denials for patients who live with multiple marginalized identities or who are less able to advocate for themselves can further entrench racial and socioeconomic inequities.
Ensuring equitable access
Our study paints a compelling picture of where different patients may face hurdles for getting preventive care, but more research is necessary to identify how to ensure equitable access.
As our study looked only at preventive services, we will also need to see how our findings generalize to other forms of health care. More research is also needed to understand how other vulnerable patient groups, such as LGBTQ+ patients or patients with multiple chronic conditions, fare when trying to access care.
Our team is currently studying how actual bills for care differ across patient groups and how patients respond when bills arrive. In our study, more than two-thirds of denied claims were never resubmitted to insurers, meaning that many billing errors go uncorrected at patients’ expense.
Equitable policy on multiple fronts can help rectify the way preventive care is inconsistently and inequitably provided. These include uniform coverage of preventive care by insurers, standardized billing practices for physicians and improved means for patients to advocate for themselves. This can help ensure that everyone has appropriate access to lifesaving health care.
Alex Hoagland, Assistant Professor of Health Economics, University of Toronto and Michal Horný, Assistant Professor of Health Policy and Management, UMass Amherst
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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ATLANTA, Feb. 19, 2025 /PRNewswire/ — GlassesUSA.com, a leader in the online eyewear industry, has just unveiled Drop 2 of its collaboration with NFL icon Von Miller. This collection showcases the results of a design process that leverages AI technology to reimagine every detail of the eyewear collection.
A fierce competitor on the field and a style innovator off it, Von Miller is the perfect partner for GlassesUSA.com’s mission to lead the eyewear industry through innovation. Together, Miller and the GlassesUSA.com team used AI to create an eyeglasses and sunglasses collection that embodies individuality, confidence, and cutting-edge design.
The Von Miller Eyewear Collection features premium acetate frames, complete with bold colors, innovative materials, and the signature VM logo embedded in the designs. Each pair is available as both prescription eyeglasses and sunglasses, giving customers more ways to express their individuality.
“Eyeglasses is about expressing who you are. I wanted to create something that empowers people to own their individuality,” said Von Miller. “Working with GlassesUSA.com and their AI technology allowed us to design a collection that makes finding your perfect pair of frames easy and exciting.”
This collaboration isn’t GlassesUSA.com’s first venture into AI. The brand has already made waves with its Pairfect Match AI, a cutting-edge tool that helps customers find their perfect frames. Now, the same innovative spirit extends into product design, showcasing GlassesUSA.com’s commitment to blending technology and creativity to revolutionize eyewear.
“At GlassesUSA.com, we leverage AI to develop innovative products and features that enhance the eyewear experience. Von was an amazing partner with an outstanding perspective on eyewear—we couldn’t have asked for a better collaborator on this project.” said Arie Tom, GlassesUSA.com’s CMO.
“We asked Von to imagine the kind of glasses he envisions—frames that push boundaries and speak to his unique sense of style,” said Lihi Kopel, Head of Design at GlassesUSA.com. “With AI, we reimagined how the frames, temples, and even the smallest details could look and feel, and brought it to life, creating something truly exceptional.”
The Von Miller Eyewear Collection is available now, exclusively at GlassesUSA.com. The drop consists of 6 styles and 17 SKUs, There are 4 optics and 2 sunglasses styles included. The color pallet is based on digital colors like digital purple, light green, gray, and metallics.
Customers can use the Virtual Try-On Tool to see how the frames look before purchasing, ensuring a perfect fit. Starting at $78, this collection redefines what’s possible in eyewear design.
Learn more at: Von Miller’s official glasses collection, exclusively at GlassesUSA.com.
About GlassesUSA.com:
Founded in 2007, GlassesUSA.com, a subsidiary of the Optimax Eyewear group, has quickly become one of the leading direct-to-consumer online eyewear retailers in the United States. We offer the largest selection of styles and brands, with over 10,000 styles of glasses, sunglasses, and contact lenses, making it easy for everyone to find their perfect pair. Our mission is to enhance our customers’ lives by delivering eyewear tailored to their unique needs, style preferences, and budgets.
By controlling the entire supply chain, from product design and manufacturing to optical lens production and the digital shopping experience, GlassesUSA.com provides exceptional savings, offering high-quality eyewear at up to 70% off traditional retail prices. Our broad selection includes popular brands like Ray-Ban, Oakley, Prada, and Gucci, as well as our own brands such as Muse, Ottoto, Revel, and Amelia E., starting from just $29, including shipping. GlassesUSA.com also offers a variety of optical lens options, coatings, and upgrades to meet every customer’s needs.
GlassesUSA.com develops and deploys innovative technology and AI-driven solutions to transform the eyewear industry and offer customers a seamless shopping experience.
GlassesUSA.com’s Tech Suite Includes:
- Pairfect Match AI™: Re-inventing the eyewear shopping experience with the power of AI. Pairfect Match AI™ provides customers with personalized frame recommendations based on their unique facial features, taking into account face shape and style preference.
- Live Try-On: An AR Virtual Mirror that bridges the physical and virtual worlds and enables users to try on thousands of glasses from home with their mobile phones.
Our products are meticulously crafted in our state-of-the-art optical lab in Atlanta, GA, with next-day shipping available across the US. GlassesUSA.com is part of the Optimax Eyewear group.
For more information, please visit https://www.GlassesUSA.com
SOURCE GlassesUSA.com
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Consumer Corner
Bipartisan Legislation Reintroduced to Protect Utilities, Ratepayers from PFAS Costs
The Water Environment Federation supports the reintroduction of the Water Systems PFAS Liability Protection Act, ensuring PFAS producers cover cleanup costs, protecting water utilities and communities from financial burdens.
WASHINGTON /PRNewswire/ — The Water Environment Federation (WEF) has expressed strong support for the reintroduction of the Water Systems PFAS Liability Protection Act. This bipartisan legislation, led by Reps. Marie Gluesenkamp Perez (D-WA) and Celeste Maloy (R-UT), aims to protect water utilities from undue financial burdens associated with per- and polyfluoroalkyl substances (PFAS) cleanup under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The bill ensures that PFAS producers, rather than the public, bear the cost of remediation.
“Water utilities and their customers should not be forced to pay remediation costs for issues they did not create,” said Ralph Exton, WEF’s Executive Director. “We applaud Representatives Gluesenkamp Perez and Maloy for their leadership in championing this critical legislation.”
The reintroduction of this legislation follows the Environmental Protection Agency’s (EPA) designation of PFOA and PFOS – two PFAS chemicals – as hazardous substances under CERCLA. This designation compels water utilities nationwide to remove these chemicals from drinking water, a process that involves significant financial costs.
By classifying PFOA and PFOS as hazardous substances, the EPA’s designation leaves water and wastewater utilities vulnerable to potential lawsuits from PFAS manufacturers. These entities may attempt to shift financial responsibility onto utilities through litigation, increasing operational costs that ultimately affect ratepayers.
“The Water Systems PFAS Liability Protection Act is a crucial step in ensuring that water and wastewater utilities — and, ultimately, the communities and ratepayers they serve — are not unfairly burdened with the costs of PFAS contamination cleanup,” said Exton. “These utilities are involuntary receivers of PFAS and did not create or profit from PFAS. However, without congressional action, they could be forced to bear immense financial and operational challenges.”
This legislation is necessary to protect utilities after their systems have been involuntarily affected by PFAS, but source control at the industrial and residential levels is a more efficient and cost-effective solution. The Minnesota Pollution Control Agency found that PFAS can be bought for $50 – $1,000 per pound. However, it costs between $2.7M and $18M per pound to remove or destroy from municipal systems depending on facility size.
Originally introduced in the previous Congress by Rep. John Curtis (R-UT), the bill received broad bipartisan support and remains an essential step toward ensuring fair and just accountability for PFAS contamination.
About WEF
The Water Environment Federation (WEF) is a not-for-profit technical and educational organization of more than 30,000 individual members and 75 affiliated Member Associations representing water quality professionals around the world. Established in 1928, WEF’s mission is to inspire the water community in pursuit of human and environmental well-being. WEF’s goals are to attract and develop a passionate workforce, cultivate a purpose-driven community to sustainably solve water challenges for all, and lead the transformation to the circular water economy.
SOURCE Water Environment Federation
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(Family Features) Clinical trials help researchers studying chronic conditions answer important questions about the diseases and their treatment options. However, uncertainty about what to expect and a lack of knowledge about how to get started can prevent patients from joining a clinical trial.
Choosing to take part in a clinical trial means helping a study team figure out if a new method of diagnosis, treatment or prevention is effective. If you live with a chronic condition, such as Crohn’s disease or ulcerative colitis, and want to help find answers for others who share your experience, a clinical trial is an option to consider.
Once you identify a study that interests you, you’ll want to talk with the professionals involved in your ongoing treatment, a clinical research coordinator and your family to gather information necessary to determine whether the clinical trial is a good fit.
To find additional information about clinical trials and begin exploring trials in your area, visit crohnscolitisfoundation.org, and consider these steps for participating in a trial.
1. Talking with Your Doctor
Your gastroenterologist and other care providers can help determine whether a clinical trial is right for you and may be able to help point you toward recommended trials. It’s important to ask if or how your doctor will continue to be involved in your care if you participate in a trial.
2. Finding a Study
If you need help beyond your care team in identifying clinical trial opportunities in your area, organizations dedicated to your condition can be a good resource. For example, the Crohn’s & Colitis Foundation offers an online Clinical Trial Finder for individuals with inflammatory bowel disease.
3. Talking with the Research Coordinator
A clinical trial research coordinator can provide details specific to your circumstances and needs. You can discuss potential benefits and risks, why the trial is being conducted and who is involved in the health care team. You can talk about past treatments and how this study may differ from your previous experiences. Other questions you might ask include what your options are if the trial doesn’t work, any costs you might expect and what your personal commitment will be.
4. Evaluating the Fit for You
Once you have the necessary information, you’ll be able to consider whether you’re ready to move forward with registering for the trial. You’ll want to weigh factors like your time commitment, travel distance and whether the trial will affect your personal or professional obligations.
Photos courtesy of Shutterstock
SOURCE:
Crohn’s & Colitis Foundation
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