High-deductible insurance plans continue to spread, subjecting an increasing share of the population to relatively expensive payments for some care. The notion is that people will become better consumers, but some may avoid needed care. One category of care almost always subject to the deductible, and often to additional copayments or coinsurance, is emergency care. A Health Affairs article describes the apparent impact of high-deductible plans on emergency room use, with a focus on high-severity conditions, those which likely really required immediate intervention. (HA Article) The study used only one Massachusetts health plan and looked at emergency care use before and after introduction of a high-deductible plan, but it should be noted that the plan at issue was not linked with a health savings account. The study used a variety of adjustments, including socioeconomic status. Among higher socioeconomic status members, those in a high-deductible plan compared to a control group showed a reduction in low-severity emergency care use but no reduction in higher-level emergency care. For the lowest socio-economic group, however, while lower acuity emergency visits did not decline, higher severity ones did, as did hospitalizations, at least initially, but with a rebound in subsequent years. This limited data set suggests that this lower socioeconomic group was not making the best decisions about avoiding care in the interest of saving money. For health plan designers and operators this indicates a need for outreach and education to help these persons make good decisions for their health, and also for overall long-run health spending.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Mental health company Headway makes, well, headway, by raising an impressive $125 million round of new capital. The company connects patients with mental health providers and facilitates providers working with...
October 11, 2023
Two health care firms owned by private equity firms are merging in a transaction supposedly valued at $3 billion. HealthComp administers self-funded plans for employers and other groups and Virgin...
September 27, 2023
NextGen, an electronic medical records firm, is being put out of its public company misery, as a PE firm will pay $1.6 billion for the one-time high-flier.
September 7, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace