Consumer-driven health plans: impact on utilization and expenditures for chronic disease sufferers.
OBJECTIVE
The impact of consumer-driven health plans (CDHPs) on utilization and expenditures for members with chronic diseases.


METHODS
Analyzed claims data from a national employer who switched from a preferred provider organization (PPO) plan to offering only CDHPs in 2005. A matched comparison group of PPO members was used. Analysis was conducted using generalized estimating equations for repeated measures.


RESULTS
Compared with the PPO group, the CDHP group had lower: outpatient visits (-36% vs -22%), laboratory services (-34.3% vs -19%), emergency room (odds ratio [OR]: 0.1 vs 0.6), and inpatient visits (OR: 0.35 vs 0.68), and medication adherence (OR: 0.7 vs 1.0). Reductions in health care expenditures were not statistically different between the groups (-28% vs -15%, P = 0.5).


CONCLUSIONS
Switching to a CDHP resulted in lower utilization and adherence. Potential underutilization of necessary services should be addressed in future research.
Nair
Kavita V
KV
School of Pharmacy, University of Colorado at Denver, Aurora, Colo 80045, USA. kavita.nair@ucdenver.edu
Park
Jinhee
J
Wolfe
Pamela
P
Saseen
Joseph J
JJ
Allen
Richard Read
RR
Ganguly
Rahul
R
D000328:Adult; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D011243:Preferred Provider Organizations; D012044:Regression Analysis; D014186:Transportation; D055815:Young Adult; D016903:Drug Monitoring