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Consumer-Directed Health Plans May Restrict Care

Many users might deny themselves necessary interventions, experts say

TUESDAY, Oct. 24, 2006 (HealthDay News) -- Consumer-directed health plans with high deductibles may help lower U.S. health care costs, but they might also deter people from seeking needed care, a new study suggests.

The study, by the nonprofit RAND Corporation, was released Tuesday.

"We know people are going to reduce their use of health care under these plans. But what we don't know is how this will affect overall health care quality and patients' health," study lead author Melinda Beeuwkes Buntin, co-director of RAND's Bing Center for Health Economics, said in a prepared statement.

The study was published online Tuesday by the journal Health Affairs.

Interest in consumer-directed health plans is growing as U.S. politicians and employers seek ways to control increasing health care costs. As of last year, 10 percent of privately insured, non-elderly American adults were enrolled in a consumer-directed plan. About 10 percent of those people had a health savings account.

This study found that if all privately insured, non-elderly Americans were switched from low-deductible health insurance plans to consumer-directed plans, there would be a one-time health care cost reduction of 4 percent to 15 percent. Those reductions would be offset by as much as half, if high-deductible plans were paired with health savings accounts.

According to the researchers, requiring people to pay more out-of-pocket expenses does make them less likely to seek "inappropriate" or "unnecessary" care -- such as demanding antibiotics for viral infections or going to a hospital emergency room for a non-critical health problem.

But would these plans also dissuade people from seeking needed medical care? That's not yet clear, the researchers said. They also expressed concern that consumer-directed plans would attract healthier people and families, leaving a larger proportion of sicker patients in traditional plans.

The researchers also noted that it can be a challenge for consumers to find reliable information on health care quality and price.

"We know there's a lot of uneven health care quality -- it's even difficult for medical professionals to judge. Now we're asking patients to become good consumers and consider not only quality of care, but price. They need more information to do that properly," Buntin said.

RAND Health is the largest independent health policy research program in the United States.

More information

The American Academy of Family Physicians has more about health insurance.

SOURCE: RAND Corporation, news release, Oct. 24, 2006
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