Effect of High-Deductible Health Plans on Medically Vulnerable
April 21, 2011
People who are medically vulnerable -- those with low incomes or chronic health problems -- who enroll in high-deductible health plans are at no more risk for cutting back on needed health care than other people who enroll in the plans, according to a new RAND Corporation study.
The RAND study examined the impact of high-deductible and consumer-directed health plans on families living in low-income areas where median income is below 200 percent of the federal poverty level. Also examined were families with a member who had one of the five most costly chronic physical illnesses -- heart disease, cancer, diabetes, high blood pressure or kidney disease.
- Medical spending declined among all families enrolled in high-deductible and consumer-directed health plans, relative to similar families in traditional plans, with the reductions among medically vulnerable families generally being similar to that seen among other families, according to researchers.
- The study found that the chronically ill were more likely to receive some preventive health care than others enrolled in high-deductible health plans.
- The chronically ill were more likely to undergo all three recommended cancer screenings than others in the high-deductible plans, but one chronically ill group, diabetics, reduced their receipt of standard recommended tests.
The study also provides new findings about specific designs for high-deductible and consumer-directed health plans that have the greatest impact on reducing costs.
- High-deductible plans coupled with health savings accounts reduced spending by a greater amount than other types of high-deductible plans.
- High-deductible plans with health savings accounts produced greater savings than high-deductible plans that had health reimbursement accounts, high-deductible plans with no accounts or plans with only moderate deductibles.
Source: "High-Deductible Health Plans Pose No Special Risks to Medically Vulnerable Populations," RAND Corporation, April 18, 2011.
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