In Focus: Are High Deductibles Making Employees Sick?

By Stephen Miller, CEBS Oct 16, 2015

Study Cautions that High-Deductible Plans Led Sick Patients to Skip Care

New research shows that when faced with a higher deductible, patients did not price shop for a better deal. Instead, both healthy and sick patients used less health care. “People who are the most likely to go past the deductible also cut back by the most, and they did that entirely under the deductible,” the researchers said, raising the possibility that higher deductibles don't lead to smarter shoppers but rather, in the long run, sicker patients. Workers with high deductibles did use less "potentially wasteful care," like imaging services, but they also cut back on "potentially valuable care," like preventive visits.


Cutting Back on Health Care Services Can Be a Good Thing, Some Contend

While those enrolled in health plans whose deductible equaled 5 percent or more of their income said they avoided a doctor or a test when they were sick, “This is not necessarily bad,” said market-oriented health policy expert John Goodman. “Roughly one-third of doctor visits are probably unnecessary. And loads of tests could easily be done without.” He added, “With a reasonably funded health savings account, the patient will forgo care only if the expected benefits are less than the expected costs. She will not forgo care for lack of money.”


CDHP Cost-Savings Maintained Over Time

Consumer-directed health plans (CDHPs) have aided employers in containing health care costs without necessarily leading to more expensive health care for patients, according to a 2015 working paper. CDHPs combine high deductibles and tax-preferred savings accounts that can be used to pay out-of-pocket expenses. Annual health care spending was 6.6 percent, 4.3 percent and 3.4 percent lower on average for the first three years respectively for companies with CDHPs when compared to companies without them.

(SHRM Online)

How to Explain High-Deductible Plans

More companies are making high-deductible health plans (HDHPs) an option—or, increasingly, the sole choice—for employer-sponsored health coverage. So it’s important to provide clear communication that helps employees understand how HDHPs operate and whether the plans are right for them. For instance, outline different situations to help employees better understand how the cost of care can vary greatly between providers, and note that most health insurance companies now provide price-estimation tools.

(SHRM Online)

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow me on Twitter.

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