Switch to High-Deductible Health Plan Detrimental for Chest Pain
Decrease in nonspecific chest pain emergency department visits and visits leading to hospitalization with employer-mandated HDHP switch
MONDAY, June 28, 2021 (HealthDay News) -- Switching to an employer-mandated high-deductible health plan (HDHP) leads to a decrease in nonspecific chest pain emergency department visits and visits leading to hospitalization, according to a study published online June 28 in Circulation.
Shih-Chuan Chou, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues used a commercial and Medicare Advantage claims database to identify members aged 19 to 63 years whose employers exclusively offered low-deductible plans in one year, then mandated enrollment in HDHPs for the next year. These were matched with members whose employers only offered low-deductible plans. Analyses included 557,501 members in the HDHP group and 5,861,990 in the control group.
The researchers observed a relative decrease of 4.3 percent in nonspecific chest pain emergency department visits and an 11.3 percent decrease in visits leading to hospitalization in association with employer-mandated HDHP switches. No significant decrease was seen in subsequent noninvasive testing or revascularization procedures. A non-statistically significant increase was seen in 30-day acute myocardial infarction admissions, while the increase was significant among members from higher-poverty neighborhoods.
"People with higher deductibles delay treatment and are sicker when they show up in the emergency room for chest pain," Chou said in a statement. "When people with low incomes are switched to high-deductible plans, they are disproportionately impacted financially and so is their health."