Workers Cut Health Visits After Switch to High-Deductible Plan
U.S. workers made fewer visits to their physicians and pharmacies after their employers moved them into a high-deductible health plan with a health savings account, according to a study published this week in Health Affairs, Modern Physician reports.
For the study, a team of researchers -- Paul Fronstin, a senior researcher at the Employee Benefit Research Institute; MartÃn SepÃºlveda, vice president of health industries research at IBM; and health policy and economics consultant M. Christopher Roebuck -- compared medical and prescription billing data for two employers between 2006 and 2010. One of the companies switched to HDHPs in January 2007, while the other did not.
The study found:
- Routine screenings for cancer declined during the year after the insurance plan switch, although screenings for breast, cervical and colorectal cancers later rebounded;
- Emergency department visits increased during the third year after the switch; and
- Hospital use remained consistent before and after the switch.
According to the researchers, their findings indicate that beneficiaries of HDHPs might forgo preventive treatment because they are confused about the plan's coverage. For example, rates for routine cancer screenings fell even though the costs for the screenings were waived under the plans. Meanwhile, the unexpected increase in ED visits might indicate a lack of adequate primary care, particularly among patients with chronic conditions, the researchers said.
According to Modern Physician, the study's finding corroborates a 2011 RAND study, which found that beneficiaries of consumer-directed plans tend to reduce their use of both medically appropriate and inappropriate services because of the potential increase in out-of-pocket costs.
The authors of the new study concluded that insurers must "design plans to incentivize primary care and prevention and educate members about what the plan covers" (Evans, Modern Physician, 6/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.