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Do HDHPs Actually Combat the Rising Cost of Healthcare?

When they were first conceived, high-deductible health plans were meant to control the rising costs of healthcare. Although HDHPs can help folks save quite a bit of money, it turns out they might be discouraging folks from seeking important preventive care.

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As with most things in life, high-deductible health plans (HDHPs) have their fair share of pros and cons. Originally designed to help manage the rising costs of healthcare, HDHPs have become a staple of open enrollment.

In 2020, more than half of private-sector workers in the U.S. — 52.9%, to be exact — enrolled in an HDHP. That’s a jump of roughly 14 percentage points from 2015’s HDHP enrollment figures. And in some ways, HDHPs have fulfilled their promise of combating rising healthcare costs.

A 2021 study from the Employee Benefit Research Institute (EBRI) determined that HDHPs encourage members to make more cost-conscious decisions than folks enrolled in traditional plans, such as PPOs. For instance, about half of HDHP enrollees said they check whether their plans cover care or medications; among enrollees in traditional health plans, that figure was only 39%.

The same study found that HDHP participants were more apt to research the cost of a doctor’s visit or medication ahead of time. They were also more likely to chat with their doctors about alternative treatment options and the associated out-of-pocket costs.

Although HDHPs have accomplished many of the goals they were initially designed to achieve, they aren’t perfect. There’s a flip side to all of these benefits.

Unintended Consequences of HDHPs

While HDHP enrollees tend to be more aware of the price of their care, they’re also more likely to delay or forgo care due to prohibitive out-of-pocket costs. According to the same EBRI study mentioned above, about 18% of HDHP enrollees said they have either delayed or skipped a medical procedure because of expenses — that figure was only 12% among traditional health plan enrollees.

And when it comes to mental health, this heightened cost-consciousness can greatly disincentivize care. A separate EBRI study examined the impact of switching from a PPO to HDHP among patients with mental health disorders like depression and anxiety. It found that moving from a PPO to an HDHP diminished the probability of patients using healthcare services. Switching from a PPO to an HDHP even affected their use of key preventive services like routine vaccinations and cancer screenings.

These findings are perhaps the most intriguing because HDHPs still fully cover specific preventive services — even if an employee hasn’t met their deductible. This combination suggests a gap in understanding among HDHP enrollees, which is dangerous considering the real costs of delayed healthcare services.

The Importance of Preventive Care

Routine preventive care can help detect, prevent, treat, and even reverse the course of medical issues. This proactive effort is the best defense against numerous chronic illnesses, and it’s up to HR leaders to help plug any gaps in benefits packages.

That starts with educating employees on what preventive care is. Even if they already file annual checkups, routine vaccinations, and cancer screenings under the category of preventive care, they may not know that mental health services are another form of preventive care. Considering how many people’s mental health has suffered as a result of the global pandemic, supporting employees’ mental well-being is vital.

And when folks stay on top of their preventive care, they are more protected from contracting an avoidable illness. This means they’re better prepared to bring their best selves to work — lowering absenteeism, presenteeism, and turnover rates for their employers while also cutting insurance costs.

However, encouraging preventive care starts with understanding why people avoid it in the first place. It’s not because employees want to be chronically ill. Many people delay or forgo crucial preventive care because they lack health insurance, lack a primary care doctor, have problems with healthcare delivery (e.g., long wait times in clinics), and can’t afford out-of-pocket costs.

While just about any health insurance plan will cover a wide array of preventive services, there are almost always some services that fall beyond our benefits plans. In those cases, a benefit like Paytient can plug existing holes and empower everyone to get the care they need. Paytient gives members a healthier way to pay for medical, vision, dental, veterinary, and mental health services.

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