High-Deductible Health Plans Reduce Health Care Cost And Utilization, Including Use Of Needed Preventive Services

Abstract

Enrollment in high-deductible health plans (HDHPs) has greatly increased in recent years. Policy makers and other stakeholders need the best available evidence about how these plans may affect health care cost and utilization, but the literature has not been comprehensively synthesized. We performed a systematic review of methodologically rigorous studies that examined the impact of HDHPs on health care utilization and costs. The plans were associated with a significant reduction in preventive care in seven of twelve studies and a significant reduction in office visits in six of eleven studies-which in turn led to a reduction in both appropriate and inappropriate care. Furthermore, bivariate analyses of data extracted from the included studies suggested that the plans may be associated with a reduction in appropriate preventive care and medication adherence. Current evidence suggests that HDHPs are associated with lower health care costs as a result of a reduction in the use of health services, including appropriate services.

Adolescent and young adult cancer care: Financial hardship and continued uncertainty

“…As Agarwal et al. noted in their 2017 systematic review of the relationship between HDHP and healthcare use, HDHP were associated with lower cost due to reduction in healthcare consumption, including preventive care …”

“…For individuals not covered by employer plans or public programs, such as Medicare or Medicaid, insurance products were offered through health exchanges. 37 Wharam et al reported earlier this year that HDHP were associated with virtually all aspects of care among newly diagnosed women with early-stage breast cancer, including imaging, biopsy, diagnosis, and chemotherapy initiation. 38 In contrast, Lu et al did not find delays in the utilization of adjuvant hormone therapy among women switching into HDHP.…”

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

“…The prevalence of high‐deductible health plans among adults enrolled in employer‐sponsored insurance is increasing rapidly over time . There is mounting evidence that enrollment in high‐deductible health plans is associated with reduced health care utilization . Theoretically, there may be at least two pathways through which high‐deductible health plan enrollment and low health care utilization are connected.…”

Association Between Switching to a High-Deductible Health Plan and Discontinuation of Type 2 Diabetes Treatment

“…8 For these reasons, controlling type 2 diabetes is "one of the most important public health challenges of the twenty-first century." 11(p1) A recent systematic review by Agarwal and colleagues 12 assessed the association between enrollment in HDHPs and clinical and economic outcomes. Consistent with the findings of the RAND Health Insurance Experiment, 13 Agarwal et al 12 concluded that HDHPs can achieve savings by reducing the use of appropriate and inappropriate care alike.…”