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.
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.
Authors: Sheila K Reiss; Dennis Ross-Degnan; Fang Zhang; Stephen B Soumerai; Alan M Zaslavsky; J Frank Wharam Journal: Health Serv Res Date: 2011-03-17 Impact factor: 3.402
Authors: Richard M Weinmeyer; Megan McHugh; Emma Coates; Sarah Bassett; Linda C O'Dwyer Journal: J Occup Environ Med Date: 2022-03-01 Impact factor: 2.306
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