High deductible health plans have expanded rapidly since their re-introduction into the private insurance market a few years ago. A new study reported in Health Affairs gives further information on their impact on patients’ decision-making. (Health Affairs article) The study interviewed patients enrolled in either high deductible or traditional coverage at Kaiser Permante’s California health plan. The interviews were designed to elicit the member’s knowledge of their deductible status, what services were covered by the deductible and how the patient may have changed care-seeking behavior in light of the deductible.
The study found that consumers with a deductible altered their care-seeking behavior more than those without a deductible did. In general, knowledge about deductibles was poor. Only 52 percent knew they had a deductible, 35% knew the amount and only 5% knew what services it applied to. This lack of knowledge had two apparent effects–people seeking care that they didn’t realize would be in the deductible and people not seeking care because they thought it was covered by a deductible. Both of these behaviors defeat the purpose of the deductible–to encourage more rational decision-making about when and what kind of care to obtain. As the authors note, work remains to be done to improve information flow and knowledge about benefit design and how to appropriately seek care within the benefit design.