Skip to main content

Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests.

Publication ,  Journal Article
Reddy, SR; Ross-Degnan, D; Zaslavsky, AM; Soumerai, SB; Wharam, JF
Published in: Med Care
January 2014

BACKGROUND: By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE: The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. RESEARCH DESIGN/SUBJECTS: We used a pre-post with comparison group study design to examine the differential change in outpatient service utilization among 7953 adults who were switched from a traditional Health Maintenance Organization plan to an HDHP compared with 7953 adults remaining in traditional plans. HDHP members had full coverage of preventive laboratory tests and modest copayments for outpatient visits, similar to controls, but faced full cost sharing under the deductible for radiology tests and laboratory tests not classified as preventive. RESULTS: Compared with controls, the HDHP group experienced moderate relative decreases in overall office visits (incidence rate ratios = 0.91, or a 9% relative reduction; 95% confidence interval: 0.88, 0.94) and visits for higher-priority (0.91; 0.85, 0.97) and lower-priority (0.89; 0.81, 0.99) chronic conditions. There were no significant differences in changes in visit rates for acute higher-priority or lower-priority conditions (both 0.93; 0.86, 1.01) or preventive laboratory tests (0.97; 0.93, 1.02). HDHP members showed moderate relative reductions in the use of general laboratory tests (0.91; 0.86, 0.97) but not radiology tests (0.97; 0.91, 1.03). CONCLUSIONS: Chronic outpatient visits declined among HDHP members, although preventive laboratory tests and acute visits remained unchanged. HDHP patients with chronic illnesses who have more contact with the health care system might be more likely to reduce utilization because of increased exposure to costs associated with ambulatory visits.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

January 2014

Volume

52

Issue

1

Start / End Page

86 / 92

Location

United States

Related Subject Headings

  • Male
  • Humans
  • Health Policy & Services
  • Female
  • Diagnostic Tests, Routine
  • Deductibles and Coinsurance
  • Ambulatory Care
  • Adult
  • 4407 Policy and administration
  • 4203 Health services and systems
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Reddy, S. R., Ross-Degnan, D., Zaslavsky, A. M., Soumerai, S. B., & Wharam, J. F. (2014). Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests. Med Care, 52(1), 86–92. https://doi.org/10.1097/MLR.0000000000000008
Reddy, Sheila R., Dennis Ross-Degnan, Alan M. Zaslavsky, Stephen B. Soumerai, and James F. Wharam. “Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests.Med Care 52, no. 1 (January 2014): 86–92. https://doi.org/10.1097/MLR.0000000000000008.
Reddy SR, Ross-Degnan D, Zaslavsky AM, Soumerai SB, Wharam JF. Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests. Med Care. 2014 Jan;52(1):86–92.
Reddy, Sheila R., et al. “Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests.Med Care, vol. 52, no. 1, Jan. 2014, pp. 86–92. Pubmed, doi:10.1097/MLR.0000000000000008.
Reddy SR, Ross-Degnan D, Zaslavsky AM, Soumerai SB, Wharam JF. Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests. Med Care. 2014 Jan;52(1):86–92.

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

January 2014

Volume

52

Issue

1

Start / End Page

86 / 92

Location

United States

Related Subject Headings

  • Male
  • Humans
  • Health Policy & Services
  • Female
  • Diagnostic Tests, Routine
  • Deductibles and Coinsurance
  • Ambulatory Care
  • Adult
  • 4407 Policy and administration
  • 4203 Health services and systems