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Does Enrollment in High‐Deductible Health Plans Encourage Price Shopping?
Author(s) -
Zhang Xinke,
Haviland Amelia,
Mehrotra Ateev,
Huckfeldt Peter,
Wagner Zachary,
Sood Neeraj
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12784
Subject(s) - deductible , health plan , medicine , actuarial science , medicare advantage , family medicine , business , advertising , health care , economics , economic growth
Objective To investigate whether enrollment in high‐deductible health plans ( HDHP s) led enrollees to choose lower‐priced providers for office visits and laboratory tests. Study Setting Claims data from more than 40 large employers. Study Design We compared the change in price for office visits and laboratory tests for enrollees who switched to HDHP s versus enrollees who remained in traditional plans. We estimated separate models for enrollees who changed providers versus those who remained with the same provider to disentangle the effects of HDHP s on provider choice and negotiated prices. Data Collection Claims data from 2004 to 2010 on 1.8 million enrollees. Principal Findings After enrollment in HDHP s, 28 percent of enrollees changed physicians for office visits (compared to 19 percent in the Traditional Plan group, p < .01); however, this did not result in a statistically significant reduction in price for office visits. About 25 percent of enrollees changed providers for laboratory tests (compared to 23 percent in the Traditional Plan group, p < .01), resulting in savings of about $2.09 or a 12.8 percent reduction in price per laboratory test. We found that HDHP s had lower negotiated prices for office visits but not for laboratory tests. Conclusions High‐deductible health plan enrollment may shift enrollees to lower cost providers, resulting in modest savings.