AMA issues recommendations to ease challenges of high-deductible health plans

The American Medical Association (AMA) is recommending a slew of policy changes payers could adopt to help mitigate the challenges related to high-deductible health plans.

During a special meeting of its House of Delegates on Tuesday, the group approved actions it says will " promote innovative health plan designs and improve access to meaningful, affordable coverage," according to an announcement.

Enrollment in HDHPs has increased steadily as plan sponsors seek solutions to mitigate rising healthcare costs. In 2010, about 25.3% of people were enrolled in a high-deductible plan, with that number rising to 40% in 2016.

People enrolled in high-deductible plans may forgo needed care due to the high out-of-pocket expenses, AMA said.

RELATED: Aetna aims to offer alternative to high-deductible plans in 2 new benefit designs

“The pandemic has prominently displayed the critical barriers posed by underinsurance, with many health plans not providing affordable coverage for services to treat chronic conditions and COVID-19- related illness,” said AMA Board Member Mario E. Motta, M.D., in a statement. “The new policy encourages research and advocacy to promote innovative health plan designs that respect patients’ unique health care needs."

"Moreover, to ensure that innovative health plans are likely to achieve their goals of enhanced access to affordable care, the new policy encourages active collaboration among organized medicine and payers during plan development,” Motta said.

AMA's policy suggestions include:

  • Offer comprehensive education to members to ensure they can effectively use their benefits to access the care they need.
  • Collaborate directly with employees in shaping the benefits they want. 
  • Tailor benefits to fit the needs of employees and their families.
  • Find ways to assist members in spreading the requisite cost-sharing throughout the year.

The AMA said its recommendations are designed to go beyond health plans and get employers thinking about ways to ease the financial burdens on employees.