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.
School of Pharmacy, University of Colorado at Denver, Aurora, Colo 80045, USA. kavita.nair@ucdenver.edu
Kavita V
KV
Nair
Jinhee
J
Park
Pamela
P
Wolfe
Joseph J
JJ
Saseen
Richard Read
RR
Allen
Rahul
R
Ganguly
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