Women pay $15 billion a year more than men in out-of-pocket costs

October 9, 2023

Source: Gebreyes, et al “Hiding in plain sight: The health care gender toll” Deloitte, October, 2023 LINK This graphic excludes maternity care.

Researchers from Deloitte evaluated a claims database with about 16 million covered lives to evaluate costs by age and gender. They found that women, on average, spend $15.3 billion more than men - largely because they use -more services. Men are more likely to wait two years between medical visits, and almost half of men have under $1000 in costs each year, but only 1/3 of women have costs of under $1000 each year. Women had higher out-of-pocket costs than men in categories across health care, including radiology, laboratory, mental health, emergency department and office visits. Women had higher out-of-pocket costs at all age groups, even when maternity costs are excluded.  

This analysis is imperfect. The sample size is large, though there are larger databases, and doesn’t include pharmacy data, which represents an increasing portion of medical and out of pocket expenses. The researchers were not evaluating the appropriateness of care, and indeed this data might suggest that many men seek too little medical care.

Previous claims research has shown that average maternity out of pocket costs were over $4500 in 2015, and previous survey research has shown that 24% of pregnant women reported that they had unmet health needs, and 60% reported that health care was unaffordable.

Implications for employers:

• This data suggests that low wage female workers are at higher risk for financial insecurity due to out-of-pocket medical expenses than low wage men.

• Employers can evaluate out-of-pocket costs for maternity care, which hits parents even as they tend to have higher expenses and lower incomes after the birth of their baby.

• Employers can do an analysis of OOP costs, by gender, to see if the higher cost burden on women is applicable to their population.

• Customized plan designs offered to low wage workers can help address this issue, although the only real solutions are lower prices, lower utilization, or improved worker health .

• Increased out-of-pocket costs for women compounds the well-known problem of women earning lower wages than men in comparable positions.

Tomorrow: COVID vaccine demand, and new vaccine

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