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The long term effects of “Consumer-Directed” health plans on preventive care use

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  • Eisenberg, Matthew D.
  • Haviland, Amelia M.
  • Mehrotra, Ateev
  • Huckfeldt, Peter J.
  • Sood, Neeraj

Abstract

“Consumer-Directed” Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches. Being offered a CDHP or enrolling in a CDHP had little or no effect on cancer screening rates but individuals increase screenings prior to enrolling in a CDHP. Our findings suggest the importance of examining CDHP effects on periodic care over the longer-term and carefully controlling for anticipatory stockpiling.

Suggested Citation

  • Eisenberg, Matthew D. & Haviland, Amelia M. & Mehrotra, Ateev & Huckfeldt, Peter J. & Sood, Neeraj, 2017. "The long term effects of “Consumer-Directed” health plans on preventive care use," Journal of Health Economics, Elsevier, vol. 55(C), pages 61-75.
    • Handle: RePEc:eee:jhecon:v:55:y:2017:i:c:p:61-75
    DOI: 10.1016/j.jhealeco.2017.06.008
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    References listed on IDEAS

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    1. Zarek C. Brot-Goldberg & Amitabh Chandra & Benjamin R. Handel & Jonathan T. Kolstad, 2017. "What does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics," The Quarterly Journal of Economics, Oxford University Press, vol. 132(3), pages 1261-1318.
    2. Haviland, Amelia M. & Eisenberg, Matthew D. & Mehrotra, Ateev & Huckfeldt, Peter J. & Sood, Neeraj, 2016. "Do “Consumer-Directed” health plans bend the cost curve over time?," Journal of Health Economics, Elsevier, vol. 46(C), pages 33-51.
    3. Haviland Amelia M & Sood Neeraj & McDevitt Roland & Marquis M Susan, 2011. "How Do Consumer-Directed Health Plans Affect Vulnerable Populations?," Forum for Health Economics & Policy, De Gruyter, vol. 14(2), pages 1-25, April.
    4. M. Kate Bundorf, 2016. "Consumer-Directed Health Plans: A Review Of The Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 83(1), pages 9-41, January.
    5. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, vol. 62(2), pages 467-475, March.
    6. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    7. Sood Neeraj & Wagner Zachary & Huckfeldt Peter & Haviland Amelia M., 2013. "Price Shopping in Consumer-Directed Health Plans," Forum for Health Economics & Policy, De Gruyter, vol. 16(1), pages 1-19, March.
    8. Peter J. Huckfeldt & Amelia Haviland & Ateev Mehrotra & Zachary Wagner & Neeraj Sood, 2015. "Patient Responses to Incentives in Consumer-directed Health Plans: Evidence from Pharmaceuticals," NBER Working Papers 20927, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Rabideau, Brendan & Eisenberg, Matthew D. & Reid, Rachel & Sood, Neeraj, 2021. "Effects of employer-offered high-deductible plans on low-value spending in the privately insured population," Journal of Health Economics, Elsevier, vol. 76(C).
    2. Salvi, Irene & Cordier, Johannes & Kuklinski, David & Vogel, Justus & Geissler, Alexander, 2023. "Price sensitivity and demand for healthcare services: Investigating demand-side financial incentives using anonymised claims data from Switzerland," Working Paper Series in Health Economics, Management and Policy 2023-06, University of St.Gallen, School of Medicine, Chair of Healthcare Management.

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