Health spending, preventive care drop with high-deductible plans

High-deductible health plans are significantly decreasing healthcare spending, but they are also linked to patients cutting back on preventive healthcare services--such as childhood immunizations, cancer screenings and routine tests for diabetes, according one of the largest assessments of these plans conducted by the RAND Corporation.

In its study of more than 800,000 families nationwide, RAND researchers found that when individuals shifted into health plans with deductibles of at least $1,000 per person, their health spending dropped by an average of 14 percent in comparison to those families with lower-deductible plans.

For consumer-directed health plans in which high-deductible health savings accounts were sponsored by employers, healthcare spending also was lower among enrolled families. However, when employer contributions to plan savings accounts accounted for more than half of an individual's deductible, savings decreased among families, according to the study which appears in the March issue of the American Journal of Managed Care.

In the study, RAND researchers examined the experiences of families insured between 2004-2005 at one of 53 large employers, with about half of the employers offering consumer-directed health plans. In 2010, a recent survey found that more than 54 percent of all large employers offered at least one high-deductible health plan to their employees.

The declines in childhood vaccination rates, cancer screening rates and routine blood tests among those with diabetes could have consequences for the future, said Amelia M. Haviland, a study co-author and a statistician at RAND, a nonprofit research organization. "If this persists, it is likely to have health consequences in the future," Haviland said in a statement.

For more details:
- see American Journal of Managed Care summary
- read the Boston Globe article

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