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High-Deductible Plans May Impede Care

Studies Show Patients Skip Doctor Visits and Medications

Controlling Health Care Costs continued...

Advocates see that as a key way to control health costs: Consumers spending their own money are less likely to get wasteful care or unnecessary tests that drive up costs.

But critics warn that without adequate information educating consumers on what separates appropriate care from wasteful spending, patients are likely to skip treatments they need in order to save money.

And these studies show that scenario is exactly, in many cases, what is happening, says Jessica Greene, PhD, a co-author of both reports.

"People were responding to the financial incentives, but it doesn't look like they were making cost-effective decisions," Greene, an assistant professor of health policy at the University of Oregon, tells WebMD.

Greene says consumer-directed plans are supposed to encourage patients to seek out information on managing their symptoms so they can decide when they need to go to the doctor or buy other services.

But one of the studies shows that while patients in lower-deductible consumer-directed plans are more likely to look up health information on the Internet or in plan booklets, patients using high-deductible plans may in fact be less likely to seek out information.

"The information piece was supposed to make the difference, and to date the information piece is not changing people's responses," she says.

The researchers urge newer plans to exempt preventive care and medications for chronic diseases from plan deductibles. That would help prevent patients from shying away from care as a way to cut costs.

Greene also says moves by some newer plans to educate policy holders about health information when they sign up for coverage "shows promise." That's instead of patients waiting until they're "in crisis" with their health to scramble for information, she says.

Balancing Care with Waste

Advocates see that as a key way to control health costs: Consumers spending their own money are less likely to get wasteful care or unnecessary tests that drive up costs. And as consumers get more savvy, the idea is that the health care industry will become more competitive, also lowering costs. The lower premiums can also give more people the opportunity to get some coverage even if they can’t afford full-premium insurance.


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