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

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.