Are CDHP Savings All Smoke and Mirrors?

Hospitals, health plans, and healthcare reform advocates all talk a lot these days about the engaged healthcare consumer—the one with skin in the game who approaches healthcare purchases with the same money-saving zeal as a coupon clipper in a supermarket.

But how hard will the average consumer work to trim a healthcare bill? It’s one thing to save money by purchasing a less expensive brand of tuna fish, quite another to score a deal on a mammogram.

For more than a decade, consumer- directed health plans (CDHPs) have been touted as a way to give the consumer some control over healthcare spending decisions. How effective has this model been?

A group of researchers at RAND Health has been looking at how CDHPs affect healthcare spending. They’ve released three reports so far, and each one has provided another piece of the puzzle to help understand how healthcare dollars are spent. While their research shows that CDHPs reduce healthcare spending, there is also evidence that those cuts have come at the expense of necessary care, not from consumers shopping more prudently for healthcare services.

The first report, released in March 2011, looked at the effect of high-deductible plans on spending. In a study of more than 800,000 families, the researchers found that people in high deductible plans spend less money on healthcare. That’s the good news. But they spend less money because they forgo preventive healthcare such as childhood shots and cancer screening. Oops, there’s the bad news.