AJMC: High-deductible health plans could reduce healthcare spending

High-deductible health plans could potentially lower healthcare spending, but they might also crimp preventive care, according to research published in the March edition of the American Journal of Managed Care.

Melinda Beeuwkes Buntin, PhD, director of public-sector initiatives at RAND Health, and colleagues conducted a retrospective study to investigate the effects of high-deductible health plans and consumer-directed health plans on healthcare spending and the use of recommended preventive care.

The authors analyzed claims and enrollment data for 808,707 households from 53 large U.S. employers, 28 of which offered high-deductible health plans or consumer-directed health plans.

Buntin and colleagues estimated the effects of enrollment in high-deductible health plans or consumer-directed health plans on healthcare cost growth between 2004 and 2005. They compared cost growth for families who were enrolled in high-deductible health plans or consumer-directed health plans for the first time in 2005 with cost growth for families who were not offered high-deductible health plans or consumer-directed health plans.

“Families enrolling in high-deductible health plans or consumer-directed health plans for the first time spent 14 percent less than similar families enrolled in conventional plans,” the authors found. “Families in firms offering a high-deductible health plan or a consumer-directed health plan spent less than those in other firms.”

According to the authors, significant savings for enrollees were realized only for plans with deductibles of at least $1,000, and savings decreased with more generous employer contributions to healthcare accounts.

“The high-deductible health plans or consumer-directed health plans with at least a $1,000 deductible significantly reduced healthcare spending, but they also reduced the use of preventive care in the first year,” the researchers stated. These findings merit additional study because of concerns about enrollee health, they said.

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