Holding the wrong insurance card may be a matter of life or death, according to new research from the University of Michigan.
A study of over 700,000 critically ill patients has revealed a troubling connection between a patient’s insurance status, the likelihood of being transferred to a specialty hospital, and a significantly higher risk of mortality.
The research, led by doctors Emily Harlan and Thomas Valley of the Division of Pulmonary and Critical Care Medicine, was motivated by a stark observation. “We’ll accept a patient,” Valley said, “but then we’re told that the patient’s insurance needs to be reviewed first.” This anecdotal evidence led to a systemic investigation of how patient transfers are handled in the U.S.
The findings are a damning indictment of a system where profit often trumps patient care. The study, which looked at patients with acute respiratory failure on ventilators between 2017 and 2021, found that those with public insurance, such as Medicare or Medicaid, or who were uninsured were less than half as likely to be transferred to a high-volume specialty hospital compared to patients with commercial insurance. Care at these specialty hospitals is directly linked to a lower risk of death for ventilator patients.
Beyond the difference in transfer rates, the timing of transfers also had a critical impact. Patients with public or no insurance were not only less likely to be transferred, but they were also moved much later in their hospital stay than those with commercial insurance. This delay, the study suggests, can be a deadly factor. Uninsured patients, in particular, were found to have a significantly higher risk of death relative to their commercially insured counterparts.
The report highlights a gaping loophole in federal regulations. While laws exist to ensure that anyone needing emergency care is stabilized, they do not require a hospital to accept a patient for transfer. This allows a patient’s insurance to become an unacceptable factor in a life-or-death decision.
The study adds to a growing body of evidence about the link between insurance status and patient outcomes. It raises the need for a closer look at hospital transfer protocols to ensure that all critically ill patients are given an equitable chance at survival, regardless of their financial status.
But for some it may also prompt the question as to whether lower cost health insurance is the right way to go for their coverage or whether alternatives such as healthshare programs present a better way to receive care.