The long term effects of “Consumer-Directed” health plans on preventive care use

Abstract

“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.