Health Plan Denials Of Preventive Care Claims More Common Among SDOH-Affected Populations

Socio-economically disadvantaged health care consumers are more at risk for benefits denials, billing errors, coverage lapses, inadequate coverage, and other barriers related to routine preventive care. In a cohort study of more than 1.5 million commercially insured people seeking preventive care, claim denials were disproportionately more common among at-risk consumers based on social determinants of health (SDOH) factors such as income, education, and race and ethnicity.

In addition to disproportionate denials for at-risk populations, the study also found differences across income, race, and ethnicity remained even after adjusting for consumer geography, service type, and insurer. Services . . .