High-deductible healthcare plans reduce both the cost and usage of healthcare services, even that of desirable services like screening for cancer. Research at the Indiana University - Purdue University Indianapolis conducted the first systematic review of studies examining the relationship between high-deductible healthcare plans and the use of healthcare services. It was found these plans reduce both the cost and the use of healthcare services.
Those reductions are the result of a decrease in patient use of many types of medical services, including desirable services like preventive care or cancer screenings, said Nir Menachemi, a professor of health policy and management and chair of the Department of Health Policy and Management in the Indiana University Richard M. Fairbanks School of Public Health at IUPUI, who is one of the authors of the paper.
"For high-deductible health plans to work in the ideal, patients need to be educated on the fact that preventive care does not usually incur out-of-pocket costs in these types of plans," Menachemi said. "Traditional insurance plans shield patients from all of the financial decisions that are made. The fact that you are shielded financially from healthcare decisions makes you potentially more likely to over-consume services, which raises the average of care for everyone and increases premiums for everyone."
High-deductible health plans have lower premiums but higher deductibles compared to traditional insurance plans. Many policymakers view high-deductible health plans as a way to curb healthcare costs by providing patients with incentives to make more cost-conscious healthcare decisions.
The review highlights the decline in use of preventive healthcare services under high-deductible plans, which another study has shown occurs when patients change their healthcare behavior and forgo needed care to save money.
However, few if any high-deductible health plans charge members for preventive screenings, suggesting patients didn't understand they could use these services at no cost, Menachemi said.
Given that nearly every healthcare reform proposal at the state and federal level involves some use of high-deductible health plans to manage costs and patients' demands for services, a synthesis of existing studies was needed to provide policymakers with the best available evidence as the U.S. moves toward a system increasingly centered on high-deductible healthcare plans, Menachemi said.
The complete research is published in the journal Health Affairs.