Healthcare Spending and Preventive Care in High-Deductible and Consumer-Directed Health Plans

Enrollment is growing in high-deductible health plans (HDHPs) offered by employers. A majority (54%) of large employers surveyed in 2010 offered at least one consumer-directed health plan option (CDHP). These plans, along with personal health savings accounts, are designed to hold down costs. Yet what is the actual effect on spending? Are people going too far in cutting back on the health care they purchase and foregoing recommended preventive care?

Researchers looked at data for two years for 53 large employers, 28 of which offered HDHPs or CDHPs to their employees. They compared costs for families who first enrolled in HDHPs and CDHPs with families who had conventional plans.

Enrollees in HDHPs were more likely to be single men, younger and in better health. Over the two years of the study, costs grew for both groups but more slowly in the higher-deductible group—4 percent versus 20 percent. Monthly costs per family increased more rapidly in firms that offered only conventional plans (rising by $165 versus $138, a savings of almost $28 in monthly costs per family in firms that offered HDHPs or CDHPs). There were significant differences in child immunizations rates and three cancer screening measures for the two groups.