Skip to main content

High-deductible health plans and costs and utilization of maternity care.

Publication ,  Journal Article
Kozhimannil, KB; Huskamp, HA; Graves, AJ; Soumerai, SB; Ross-Degnan, D; Wharam, JF
Published in: Am J Manag Care
January 2011

OBJECTIVE: To evaluate the impact of switching from an HMO to a high-deductible health plan on the costs and utilization of maternity care. STUDY DESIGN: Pre–post design, with a control group. METHODS: We compared 229 women who delivered babies before or after their employers mandated a switch from HMO coverage to a high-deductible health plan, with a control group of 2180 matched women who delivered babies while their employers remained in an HMO plan. Administrative claims from a large Massachusetts-based health insurance program were used in a difference-in-differences regression analysis. RESULTS: Mean out-of-pocket maternity care costs for high-deductible group members increased from $356 for women who delivered before the insurance transition (n = 86) to $942 for women who delivered after the transition (n = 143), compared with a change from $262 (n = 711) to $282 (n = 1569) for HMO members, a relative increase of 106% (P <.001) for high-deductible members. Delivery after transition to a high-deductible plan was not associated with changes in the odds of receiving early prenatal care (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.32-3.19), recommended prenatal visits (OR, 1.64; 95% CI, 0.89-3.02), or postpartum care (OR, 0.74; 95% CI, 0.42-1.32). CONCLUSIONS: Switching from an HMO to a high-deductible plan with exemptions for routine care increased out-of-pocket member costs for maternity care, but had no apparent adverse impacts on receipt of recommended prenatal and postpartum care.

Duke Scholars

Published In

Am J Manag Care

EISSN

1936-2692

Publication Date

January 2011

Volume

17

Issue

1

Start / End Page

e17 / e25

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Regression Analysis
  • Prenatal Care
  • Pregnancy
  • Postnatal Care
  • Massachusetts
  • Insurance Coverage
  • Insurance Claim Review
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kozhimannil, K. B., Huskamp, H. A., Graves, A. J., Soumerai, S. B., Ross-Degnan, D., & Wharam, J. F. (2011). High-deductible health plans and costs and utilization of maternity care. Am J Manag Care, 17(1), e17–e25.
Kozhimannil, Katy Backes, Haiden A. Huskamp, Amy Johnson Graves, Stephen B. Soumerai, Dennis Ross-Degnan, and J Frank Wharam. “High-deductible health plans and costs and utilization of maternity care.Am J Manag Care 17, no. 1 (January 2011): e17–25.
Kozhimannil KB, Huskamp HA, Graves AJ, Soumerai SB, Ross-Degnan D, Wharam JF. High-deductible health plans and costs and utilization of maternity care. Am J Manag Care. 2011 Jan;17(1):e17–25.
Kozhimannil, Katy Backes, et al. “High-deductible health plans and costs and utilization of maternity care.Am J Manag Care, vol. 17, no. 1, Jan. 2011, pp. e17–25.
Kozhimannil KB, Huskamp HA, Graves AJ, Soumerai SB, Ross-Degnan D, Wharam JF. High-deductible health plans and costs and utilization of maternity care. Am J Manag Care. 2011 Jan;17(1):e17–e25.

Published In

Am J Manag Care

EISSN

1936-2692

Publication Date

January 2011

Volume

17

Issue

1

Start / End Page

e17 / e25

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Regression Analysis
  • Prenatal Care
  • Pregnancy
  • Postnatal Care
  • Massachusetts
  • Insurance Coverage
  • Insurance Claim Review
  • Humans