Does Enrollment in High-Deductible Health Plans Encourage Price Shopping?

Xinke Zhang, Amelia Haviland, Ateev Mehrotra, Peter Huckfeldt, Zachary Wagner, Neeraj Sood

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: To investigate whether enrollment in high-deductible health plans (HDHPs) led enrollees to choose lower-priced providers for office visits and laboratory tests. Study Setting: Claims data from more than 40 large employers. Study Design: We compared the change in price for office visits and laboratory tests for enrollees who switched to HDHPs versus enrollees who remained in traditional plans. We estimated separate models for enrollees who changed providers versus those who remained with the same provider to disentangle the effects of HDHPs on provider choice and negotiated prices. Data Collection: Claims data from 2004 to 2010 on 1.8 million enrollees. Principal Findings: After enrollment in HDHPs, 28 percent of enrollees changed physicians for office visits (compared to 19 percent in the Traditional Plan group, p <.01); however, this did not result in a statistically significant reduction in price for office visits. About 25 percent of enrollees changed providers for laboratory tests (compared to 23 percent in the Traditional Plan group, p <.01), resulting in savings of about $2.09 or a 12.8 percent reduction in price per laboratory test. We found that HDHPs had lower negotiated prices for office visits but not for laboratory tests. Conclusions: High-deductible health plan enrollment may shift enrollees to lower cost providers, resulting in modest savings.

Original languageEnglish (US)
Pages (from-to)2718-2734
Number of pages17
JournalHealth services research
StatePublished - Aug 2018

Bibliographical note

Funding Information:
Joint Acknowledgment/Disclosure Statement: This research was supported by a grant (No. R01AG043850) from the National Institutes of Health. Disclosures: None. Disclaimer: None.

Publisher Copyright:
© Health Research and Educational Trust


  • High-deductible health plans
  • benefit design
  • price shopping
  • transparency
  • value


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