title: Consumer-directed health plans reduce the long-term use of outpatient physician visits and prescription drugs.
abstract: Consumer-directed health plans (CDHPs) are designed to make employees more cost- and health-conscious by exposing them more directly to the costs of their care, which should lower demand for care and, in turn, control premium growth. These features have made consumer-directed plans increasingly attractive to employers. We explored effects of consumer-directed health plans on health care and preventive care use, using data from two large employers-one that adopted a CDHP in 2007 and another with no CDHP. Our study had mixed results relative to expectations. After four years under the CDHP, there were 0.26 fewer physician office visits per enrollee per year and 0.85 fewer prescriptions filled, but there were 0.018 more emergency department visits. Also, the likelihood of receiving recommended cancer screenings was lower under the CDHP after one year and, even after recovering somewhat, still lower than baseline at the study's conclusion. If CDHPs succeed in getting people to make more cost-sensitive decisions, plan sponsors will have to design plans to incentivize primary care and prevention and educate members about what the plan covers.
authors.affiliation: Employee Benefit Research Institute, Washington, DC, USA. fronstin@ebri.org
authors.forename: Paul
authors.initials: P
authors.lastname: Fronstin
authors.forename: Martín J
authors.initials: MJ
authors.lastname: Sepúlveda
authors.forename: M Christopher
authors.initials: MC
authors.lastname: Roebuck
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000639:trends; D003256:Community Participation / Q000191:economics* / Q000639:trends; D003363:Cost Control / Q000379:methods; D003669:Deductibles and Coinsurance / Q000191:economics / Q000639:trends; D055088:Early Detection of Cancer / Q000706:statistics & numerical data / Q000639:trends; D004636:Emergency Service, Hospital / Q000191:economics / Q000639:trends; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000639:trends; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008297:Male; D020402:Medical Savings Accounts / Q000191:economics* / Q000639:trends; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics / Q000639:trends; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use; D014481:United States; D055815:Young Adult
chemical_list: D055553:Prescription Drugs
keywords: CDHP; Consumer-Directed Health Plan; Health Savings Account; Prevention; Screening