IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/15106.html
   My bibliography  Save this paper

The Effects of Consumer-Directed Health Plans on Health Care Spending

Author

Listed:
  • Anthony T. Lo Sasso
  • Lorens A. Helmchen
  • Robert Kaestner

Abstract

We use unique data from an insurer that exclusively offers high-deductible, "consumer-directed" health plans to identify the effect of plan features, notably the spending account, on health care spending. Our results show that the marginal dollar in the spending account is entirely spent on outpatient and pharmacy services. In contrast, inpatient and out-of-pocket spending were not responsive to the amount in the spending account. Our results represent the first plausibly causal estimates of the components of consumer-driven health plans on health spending. The magnitudes of the effects suggest important moral hazard consequences to higher spending account levels.

Suggested Citation

  • Anthony T. Lo Sasso & Lorens A. Helmchen & Robert Kaestner, 2009. "The Effects of Consumer-Directed Health Plans on Health Care Spending," NBER Working Papers 15106, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:15106 Note: HE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w15106.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
    2. Dionne, Georges & St-Michel, Pierre, 1991. "Workers' Compensation and Moral Hazard," The Review of Economics and Statistics, MIT Press, vol. 73(2), pages 236-244, May.
    3. Keeler, Emmett B & Newhouse, Joseph P & Phelps, C E, 1977. "Deductibles and the Demand for Medical Care Services: The Theory of a Consumer Facing a Variable Price Schedule under Uncertainty," Econometrica, Econometric Society, vol. 45(3), pages 641-655, April.
    4. Alma Cohen & Peter Siegelman, 2010. "Testing for Adverse Selection in Insurance Markets," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 39-84.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    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. Liran Einav & Amy Finkelstein & Paul Schrimpf, 2013. "The Response of Drug Expenditures to Non-Linear Contract Design: Evidence from Medicare Part D," NBER Working Papers 19393, National Bureau of Economic Research, Inc.
    4. Anne C. Duke & Brenda J. Cude, 2016. "Motivating Personal Contributions to Health Savings Accounts," Journal of Consumer Affairs, Wiley Blackwell, vol. 50(3), pages 652-665, November.
    5. Georges Dionne, 2012. "The Empirical Measure of Information Problems with Emphasis on Insurance Fraud and Dynamic Data," Cahiers de recherche 1233, CIRPEE.
    6. 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.
    7. Kaestner, Robert & Sasso, Anthony T. Lo, 2015. "Does seeing the doctor more often keep you out of the hospital?," Journal of Health Economics, Elsevier, vol. 39(C), pages 259-272.
    8. repec:spr:eujhec:v:18:y:2017:i:6:d:10.1007_s10198-016-0827-9 is not listed on IDEAS
    9. Stefan Pichler & Jan Ruffner, 2016. "Does it really make a difference? Health care utilization with two high deductible health care plans," KOF Working papers 16-404, KOF Swiss Economic Institute, ETH Zurich.
    10. Song Chen & Anthony Lo Sasso & Aneesh Nandam, 2013. "Who funds their health savings account and why?," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 219-232, December.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:15106. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (). General contact details of provider: http://edirc.repec.org/data/nberrus.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.