High-deductible health plans' effect same for rich and poor

Patients with chronic conditions also are not disproportionately affected by the plans, which cover more than 10 million Americans.

By Kevin B. O’Reilly — Posted May 16, 2011

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Patients with low incomes or chronic conditions who are covered by high-deductible health plans are not likelier than well-to-do or healthy patients to skip preventive care, said a study published in April.

Researchers examined data shared by 59 large U.S. employers from 2003 to 2007, comparing the health care use of nearly 370,000 families covered by a variety of plans with low, moderate and high deductibles.

Patients enrolled in the high-deductible plans slashed their health spending by as much as 29%. But the drop in spending was similar among families below 200% of the poverty line and those above it, said the study, published in the Forum for Health Economics & Policy.

Use of preventive care such as cancer screenings and hemoglobin A1c tests for diabetics fell by as much as 10%, but the drop was similar for well-to-do households and those with lower incomes. Patients with a costly chronic condition such as heart disease or hypertension had the smallest drops in spending and use of preventive services.

"We have at least some evidence that medically recommended care is being reduced, but I think on the whole it's a positive message," said Roland McDevitt, PhD, who co-wrote the study with researchers from RAND Corp. and the University of Southern California. "It looks like we're not seeing a disproportionate effect on vulnerable populations."

More than 10 million people are enrolled in high-deductible plans, says a May 2010 report by America's Health Insurance Plans. That figure is likely to rise as employers seek to cut their medical costs, said McDevitt, director of health care research at consulting firm Towers Watson.

The American Medical Association has policy supporting health savings accounts, which are often paired with high-deductible plans, as one form of financing health care. The AMA also supports first-dollar coverage of preventive services.

Back to top

External links

"How Do Consumer-Directed Health Plans Affect Vulnerable Populations?" Forum for Health Economics & Policy, April 17 (link)

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn