Keep on harping

This month’s issue of Health Affairs contains two academic studies about the impact of consumer-directed health plans on consumer behaviors: one about CDHPs and drugs, and the other specifically about health service seeking behavior.

The papers examined whether such plans would make consumers more “cost conscious” as proponents alleged they would. The evidence, so far, is: not really in a good way.

In the drug article, consumers were no more likely to seek out generics to save money. However, consumers with higher deductibles were two to three times more likely to skip or stop using high blood pressure, asthma and cholesterol drugs.

In the other article, consumers who weren’t already really involved in seeking out information about their health treatments weren’t going to be significantly more interested once they enrolled in these plans, however, those in high-deductible plans were a teensy bit more likelyto be more engaged than those in traditional plans.

What I found interesting about both studies was they compared behaviors of consumers in low- and high-deductible plans. As expected, consumers in high-deductible plans immediately ratcheted down their health consumption — lowering drug doses and skipping doctors visits to save money. But by the second year, even consumers in lower-deductible consumer-directed plans started delaying and forgoing care.

These studies, quantifying and examining real consumer behavior in response to these health plan creations will be an important piece as we proceed with reform on the state and national level — with some (not us) pushing for more consumer-directed involvement.

Health Access California promotes quality, affordable health care for all Californians.

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