High-Deductible Health Plans and Consumer Behaviors Still a Mismatch

Another study found that most employees with high-deductible health plans (HDHPs) aren’t comparison shopping for medical care.

You can force employees into a high-deductible health plan but you can’t make them shop for care.
That’s the takeaway from the latest study that found that the use of HDHPs has yet to trigger employees to engage in traditional consumer behaviors when it comes to paying for their own medical services. 
Researchers from the VA Ann Arbor Healthcare System and the University of Michigan Medical School conducted the study, which appeared in JAMA Internal Medicine. The study is based on a survey of a representative sample of 1,637 adults age 18 to 64 who were enrolled in an HDHP for at least the past 12 months. An HDHP has an annual deductible of at least $1,300 for individual coverage and at least $2,600 for family coverage.
Some 85 percent of the survey respondents had employer-sponsored health insurance, 84 percent were employed, 58 percent had an account like a health savings account to pay for medical expenses, and 42 percent suffered from a chronic medical condition.
The researchers asked the respondents if they engaged in five consumer behaviors commonly used to make informed purchases of retail goods and services. Of the respondents:

  • 40 percent saved for future medical services
  • 25 percent discussed the cost of a medical service with a clinician
  • 14 percent compared prices for a medical service
  • 14 percent compared quality ratings for a medical service
  • 6 percent tried to negotiate a price for a medical service

“We found that few individuals enrolled in HDHPs in the United State are engaging in consumer behaviors, and those that are could be realizing more benefits,” the researcher said.
The most common services for which the respondents engaged in consumer behavior were prescription medications and outpatient-care visits. For example, of the 248 respondents who said they compared prices for a medical service, 61 percent did so for prescription drugs. And of the 204 respondents who said they compared quality ratings for a medical service, 71 percent did so for an outpatient visit.
If employers want their workers with HDHPs to be more astute health care shoppers and spend less on health care services, employers need to do more, the researchers said.
“Employers and insurers could go beyond disseminating price information to help patients learn how to use this information in health care decisions,” they said.
The admonition is particularly noteworthy for Minnesota employers. Some 50.9 percent of employees in the state are enrolled in HDHPs compared with 42.6 percent of employees nationally, according to the latest available data from the State Health Access Data Assistance Center, which is affiliated with the University of Minnesota School of Public Health.