High-deductible health plans don't significantly curb spending on 26 low-value services

Consumer-directed health plans, a type of high-deductible health plan, didn't significantly reduce spending for 26 low-value services from 2011 to 2013, according to a study published in the American Journal of Managed Care.

The study — led by researchers from the University of Southern California Schaeffer Center for Health Policy and Economics and the RAND Corp. — adds to several studies indicating HDHPs may not lower healthcare spending as much as intended.

For the study, researchers examined insurance claims of roughly 376,000 adult patients enrolled in a plan under a national commercial payer between 2011 and 2013. They measured healthcare spending on 26 low-value services with unclear or no clinical benefit, comparing how spending changed on low-value services for patients switching to a CDHP from a traditional plan.

While transitioning to a CDHP was linked with a $231.60 decrease in annual outpatient spending, researchers found no significant reduction in annual spending for 26 low-value services. In addition, while researchers uncovered a small decrease in low-value spending on imaging, it was not relative to overall imaging. No significant declines were noted in low-value laboratory spending.

"As CDHP enrollment continues to grow, our findings suggest that their broadly increased overall cost sharing may encourage patients to cut spending indiscriminately, rather than to specifically reduce low-value care," the study authors concluded. "Modification of the consumer incentives in CDHPs, more targeted [value-based insurance designs], or efforts focused on providers, rather than patients, may be necessary to expressly reduce wasteful spending."

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