“Consumer-Directed” Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches. Being offered a CDHP or enrolling in a CDHP had little or no effect on cancer screening rates but individuals increase screenings prior to enrolling in a CDHP. Our findings suggest the importance of examining CDHP effects on periodic care over the longer-term and carefully controlling for anticipatory stockpiling.
Bibliographical noteFunding Information:
This study was funded in part by a grant from the National Institute of Aging (NIA) and the NIH Common Fund for Health Economics (Grant R01-AG043850). Prior grants from the California Health Care Foundation and the Robert Wood Johnson Foundation enabled the construction of the data source for this study. We thank participants at the American Society of Health Economists meeting in 2014, International Health Economics Association Meeting in 2015, and two anonymous reviewers for helpful comments. Any remaining errors are our own.
- High deductible health plans
- Preventive care