Consumer-driven health plans (CDHP) — hailed since their inception in 2000 as a tool to help control costs — are resulting in members forgoing care and discontinuing drugs to treat chronic medical problems, according to two newly published studies.
Proposed as a way to have patients make “better health care choices” and comparison shopping their medical needs, members pay up-front deductibles either out-of-pocket or from a dedicated health-care account before insurance coverage begins. It is also used by companies who want to have lower premiums but still claim that they are offering health insurance. Proponents include George W Bush and John McCain, big surprise.
The new research — published in Health Affairs and led by two University of Oregon policy experts — offers partial fuel to critics: Many CDHP enrollees were more likely to quit taking drugs that control high blood pressure and cholesterol-lowering medications than were participants with over medical coverage, said Jessica Greene, professor of health policy in the UO’s department of planning, public policy and management.
“CDHPs seem to influence people because of the higher out-of-pocket costs, but not by making people more informed health-care consumers,” Greene said. “We did not see more use of health information, higher generic drug use or more comparison shopping in terms of diagnostic tests as predicted by proponents. What we did see was that people were two to three times more likely to drop off drugs that treat certain chronic illnesses.
“By cutting back on antihypertensive and lipid-lowering drugs,” she added, “there may end up being higher health-care costs in the long run, so these consumers may be making short-sighted, cost-saving decisions that may have higher-cost and unfortunate health ramifications.”
An alarming trend, researchers noted, was that in the second year of the study even some enrollees of a lower-deductible CDHP plan began to postpone or delay medical procedures or to take lower-than-prescribed doses of prescription drugs to save money.
I don’t know about all of you but if I did not have insurance my Femara would be $348 per month and most of us are on more than one prescription. Paying that out of pocket would be difficult for most of us. If your company is making insurance changes investigate them carefully as this may well be one of them.