Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health Care: Enrollees with Skin in the Game

While high-deductible health plans are sold as a way for consumers to take greater control over managing their medical costs, research by Sood and colleagues found that people on those plans are no better at price shopping for health care professionals or services than people on traditional insurance. About 1 in 4 US employees is enrolled in a high-deductible plan, and 80 percent of the people insured through the health care exchanges are enrolled in a high-deductible plan. Sixty percent of high-deductible enrollees surveyed said they believe that there are large differences in prices across health care providers. Few of those high-deductible enrollees—17 percent—believe that higher-priced physicians provide better care, and 71 percent believe out-of-pocket costs are important to consider when choosing a doctor. The researchers found that during their last use of medical care, the high-deductible plan enrollees were no more likely than traditional plan enrollees to consider going to another professional for care (11 percent versus 10 percent) or to compare out-of-pocket costs across health care professionals (4 percent versus 3 percent). Studies have shown that people on high-deductible plans may save money—not because they shop for better deals but because they cut back on doctor visits.

The full study can be viewed at JAMA Internal Medicine. A press release is available here.

Citation: Sinaiko, A. D., Mehrotra, A., & Sood, N. (2016). Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health Care: Enrollees with Skin in the Game. JAMA Internal Medicine.