Quality, Access and Cost of Care.
Weber State University
This paper briefly examines five published research articles on the various effects of consumer-driven health care (CDHC) and high deductible health plans (HDHP). Consumer directed health care has been define many ways. The term commonly applies to an insurance product that has a high deductible with an associated health savings account (HSA) and a limit on out-of-pocket expenditures. Enrollment trends for HDHP programs will be reviewed including concepts of market segmentation as well as the effects of coverage to overall utilizations of care for both medical treatment and preventive services.
Effects of Consumer Driven Health Care and High Deductible Health Plans;
Quality, Access and Cost of Care
As healthcare costs continue to rise and the fields of medicine and insurance become more complex, it is important to continue to re-examine ways in which users of the healthcare system purchase and consume healthcare services. Society must learn to balance the three-legged stool of cost, access and quality of the healthcare that can be provided. Consumer driven health care has emerged in recent years as one of the most potent ideas in health care reform. Originally thought as a solution to all three aspects of care, High Deductible and Consumer Driven Health Care was an approach to insurance and healthcare that was designed to minimize healthcare costs, create a more cost conscious consumer base by creating incentives to use care wisely, increase access to affordable healthcare and increase positive patient health outcomes.
History and Development The traditional health insurance model as a whole is an anomaly in the insurance world. Insurance coverage is purchased for a variety of reasons from life to auto, disability to home. For the majority of these policies, insured parties do everything possible in order to avoid filing a claim. Either for a fear of premium increases or deductible pay outs, consumers will go out of their way to avoid incurring additional expenses associated with filing a claim. Health insurance however, creates an environment in which some consumers look at maximizing their benefits by filing numerous claims. In the case of a PPO plan, consumers have very little to no out of pocket costs. The question of whether to be seen by a physician, even for minor ailments is an easy one because it contains little to no risk or cost for the consumer. High deductible plans however, shift the first dollars spent to the patient’s responsibility, originally believed to result in a more conscious use of healthcare services. “When selecting a health plan, consumers can choose to pay a larger premium amount monthly and least the point of service (typical of the PPO plan), or a small premium amount monthly and a larger amount at the point of service (typical of the HDHP plan).” (Water, Change, Cecil, Kasteridis & Mirvis, 2011, p.158) Proponents of the High Deductible Health Plans believe that people should have more “skin in the game” and individuals will make better decisions if they face more of the cost of care.
A number of policies have paved that way for a shift toward Consumer Driven/High Deductible Health Plans. In 2003, legislation was implemented allowing for tax-free health savings plans (HSAs) to be paired with high-deductible insurance policies. This arrangement was intended to make consumers more conscious of cost of health expenditures without discouraging the access of care when warranted and preventing financial risk of catastrophic illnesses. (Buntin, et al., 2006, p. 516-517)
The adoption of High Deductible Health Plans has been well received. According to Buntin, Haviland, McDevitt and Sood (2011), “A survey of large employers at the beginning of 2010 found that more than 54% offered at…