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Comparative Study
. 2020 Feb;55(1):119-127.
doi: 10.1111/1475-6773.13223. Epub 2019 Oct 27.

The role of plan choice in health care utilization of high-deductible plan enrollees

Salam Abdus  1
Affiliations
Comparative Study

The role of plan choice in health care utilization of high-deductible plan enrollees

Salam Abdus. Health Serv Res. 2020 Feb.

Abstract

Objective: To study whether the negative association between enrollment in high-deductible plans and health care utilization is driven by reverse moral hazard or favorable selection, by examining adults with and without a choice of plans.

Data source: 2011-2016 Medical Expenditure Panel Survey Household Component data on nonelderly adults enrolled in employer-sponsored insurance.

Study design: Four types of plans were examined: high-deductible health plans (HDHPs), consumer-directed health plans (CDHPs), low-deductible health plans (LDHPs), and no-deductible health plans (NDHPs). Multivariate logistic regressions of various measures of health care utilization were conducted to estimate the differences in utilization across plan types among those who had a choice of plans and those who did not.

Principal findings: Among adults with a choice of plans, HDHP enrollees had lower levels of utilization compared with those of the NDHP enrollees for any ambulatory visit, any specialist visit, and most preventive services. Among adults without any choice of plans, the differences between HDHP enrollees and NDHP enrollees were not statistically significant.

Conclusions: The differences between those with and without choice of plans in the relationship between HDHP enrollment and health care utilization might possibly be explained by favorable selection.

Keywords: health care utilization; high deductible; plan choice.

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References

    1. Claxton G, Levitt L, Rae M, Sawyer B. Increases in cost‐sharing payments continue to outpace wage growth. Washington, DC: Peterson Center on Health Care and Kaiser Family Foundation; June 2018. https://www.healthsystemtracker.org/brief/increases-in-cost-sharing-paym.... Accessed September 7, 2018.
    1. Agarwal R, Mazurenko O, Menachemi N. High‐deductible health plans reduce health care cost and utilization, including use of needed preventive services. Health Affairs (Millwood). 2017;36(10):1762‐1768. - PubMed
    1. Abraham JM, DeLeire T, Royalty AB. Moral hazard matters: measuring relative rates of underinsurance using threshold measures. Health Serv Res. 2010;45(3):806‐824. - PMC - PubMed
    1. The Kaiser Family Foundation . 2018 Employer health benefits survey. https://www.kff.org/health-costs/report/2018-employer-health-benefits-su.... Accessed December 20, 2018.
    1. Buchmueller TC. Consumer‐oriented health care reform strategies: a review of the evidence on managed competition and consumer‐directed health insurance. Milbank Q. 2009;87(4):820‐841. - PMC - PubMed

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