Switching to High-Deductible Health Plans: It Is Going to Be a Bumpy Ride
Authors: Mark V. Pauly
Journal: Annals of Internal Medicine (2018)

Editorials18 December 2018Switching to High-Deductible Health Plans: It Is Going to Be a Bumpy RideMark V. Pauly, PhDMark V. Pauly, PhDUniversity of Pennsylvania, Philadelphia, Pennsylvania (M.V.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2825 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Nearly 30% of persons with employer-based health insurance are covered by high-deductible plans (1). A large market share for any new product usually means that it offers advantages over alternatives, but opinions differ about the net benefit of high-deductible plans. Advocates point to the more affordable premiums and evidence that moving into a high-deductible plan decreases total average spending (2). Critics are concerned that the costly care sacrificed to generate such savings may have clinical value that in some way exceeds the value of the reductions in expected spending (3).In this issue, Wharam and colleagues take a useful step ...References1. Claxton G, Rae M, Long M, Damico A, Whitmore H. The Kaiser Family Foundation Employer Health Benefits 2018 Annual Survey. 3 October 2018. Accessed at http://files.kff.org/attachment/Report-Employer-Health-Benefits-Annual-Survey-2018 on 1 November 2018. Google Scholar2. Agarwal R, Mazurenko O, Menachemi N. High-deductible health plans reduce health care cost and utilization, including use of needed preventive services. Health Aff (Millwood). 2017;36:1762-8. [PMID: 28971921] doi:10.1377/hlthaff.2017.0610 CrossrefMedlineGoogle Scholar3. Rosato D. The downside of high deductible health insurance. Consumer Reports. 19 February 2016. Accessed at www.consumerreports.org/health-insurance/downside-of-high-deductible-health-insurance on 1 November 2018. Google Scholar4. Wharam JF, Lu CY, Zhang F, Callahan M, Xu X, Wallace J, et al. High-deductible insurance and delay in care for the macrovascular complications of diabetes. Ann Intern Med. 2018;169:845-54. doi:10.7326/M17-3365 LinkGoogle Scholar5. Small L. New bill would mean more flexibility for high-deductible health plans. Fierce Healthcare. 9 February 2018. Accessed at www.fiercehealthcare.com/regulatory/high-deductible-health-plans-bill-chronic-conditions on 1 November 2018. Google Scholar6. Brot-Goldberg ZC, Chandra A, Handel BR, Kolstad JT. What does a deductible do? The impact of cost-sharing on health care prices, quantities, and spending dynamics. Q J Econ. 2017;132:1261-318. CrossrefGoogle Scholar7. Newhouse JP; Insurance Experiment Group. Free for All? Lessons from the RAND Health Insurance Experiment. Cambridge, MA: Harvard Univ Pr; 1993. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania, Philadelphia, Pennsylvania (M.V.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2825.Corresponding Author: Mark V. Pauly, PhD, Department of Health Care Management, The Wharton School, University of Pennsylvania, 208 Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104; e-mail, [email protected]upenn.edu.This article was published at Annals.org on 20 November 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh-Deductible Insurance and Delay in Care for the Macrovascular Complications of Diabetes J. Frank Wharam , Christine Y. Lu , Fang Zhang , Matthew Callahan , Xin Xu , Jamie Wallace , Stephen Soumerai , Dennis Ross-Degnan , and Joseph P. Newhouse Metrics Cited byInsured but not Protected: Time to Eliminate Cost-sharing for Trauma Care 18 December 2018Volume 169, Issue 12Page: 879-880KeywordsBehaviorDatabasesDisclosureForecastingHealth careHealth information technologyHealth insuranceTaxes ePublished: 20 November 2018 Issue Published: 18 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...