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Cost-Sharing (Hi Deductible) "Health" Plans--Less $ and Prevention

This article is posted in: 

Patient or Guardian Responsibility in the Cost of Care

Employers have been cost-sharing to mitigate the ever rising healthcare premium costs.  Examples: HMO's/PPO's now see annual deductibles in 83% of people in employer-sponsored coverage [up from 53% in 2006], co-insurance, co-pays and, more recently 'high-deductible' Health Plans (HDHP) [In 2016, 29% of covered employees were in an HDHP, up from 8% in 2008.] 

Robert E. Goff [with permission]  Aaron Simon, University Physicians Network, NYC. News and Notes,  12/13/16


Recent past history of this cost-sharing phenomenon

A large study on the effect of having high-deductibles in health plans shows that while health spending lessens, so is preventive efforts such as immunizations, mammograms, cervical and colorectal cancer screenings, despite waiving fees for preventive health care.

"High-deductible and consumer-directed health plans have been gaining favor as one way to help control health care costs. By 2009, about 20% of Americans with employer-sponsored health coverage were enrolled in such plans. A 2010 survey found that more than 54% of large employers offered at least one high-deductible health plan to their employees.  Health care reform is expected to further encourage enrollment in high-deductible health plans as such plans are expected to be a key offering in the insurance exchanges being set up in many states to help the uninsured find health coverage.

The RAND study found that overall, health costs grew for people enrolled in both high-deductible and traditional plans." However, they grew more slowly in the high-deductible group, especially when deductibles exceeded $1,000 per person. "Among those with high-deductible health plans, spending was lower on both inpatient and outpatient medical services, as well as prescription drugs. Spending for emergency care did not differ."

Per co-author, Amelia M. Haviland, "'We saw that patients reduced preventive care, and if this persists, it is likely to have health consequences in the future," Haviland said. "These cutbacks could cause a spike in health care costs down the road if people end up sicker and need more-intensive treatment.'

The drop in preventive care happened even though the high-deductible plans in the study waived the need to pay a deductible when receiving such care. This suggests that enrollees in high-deductible plans either did not understand this part of their policy or some other factor discouraged them from getting preventive care."

See the RAND Corporation's findings  as published in: The American Journal of Managed Care, v. 17, no. 3, Mar. 2011, p. 222-230