Consumer-driven health plans: impact on utilization and expenditures for chronic disease sufferers

J Occup Environ Med. 2009 May;51(5):594-603. doi: 10.1097/JOM.0b013e31819b8c1c.

Abstract

Objectives: The impact of consumer-driven health plans (CDHPs) on utilization and expenditures for members with chronic diseases.

Methods: Analyzed claims data from a national employer who switched from a preferred provider organization (PPO) plan to offering only CDHPs in 2005. A matched comparison group of PPO members was used. Analysis was conducted using generalized estimating equations for repeated measures.

Results: Compared with the PPO group, the CDHP group had lower: outpatient visits (-36% vs -22%), laboratory services (-34.3% vs -19%), emergency room (odds ratio [OR]: 0.1 vs 0.6), and inpatient visits (OR: 0.35 vs 0.68), and medication adherence (OR: 0.7 vs 1.0). Reductions in health care expenditures were not statistically different between the groups (-28% vs -15%, P = 0.5).

Conclusions: Switching to a CDHP resulted in lower utilization and adherence. Potential underutilization of necessary services should be addressed in future research.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease / economics*
  • Chronic Disease / epidemiology
  • Chronic Disease / therapy*
  • Female
  • Health Benefit Plans, Employee / economics
  • Health Benefit Plans, Employee / statistics & numerical data*
  • Health Care Costs
  • Health Services / economics*
  • Health Services / statistics & numerical data*
  • Hospitalization
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • North America / epidemiology
  • Preferred Provider Organizations
  • Regression Analysis
  • Transportation
  • Young Adult