The second report, released in April 2011, looked at the effect of high-deductible plans on the medically vulnerable. It found that people with chronic health problems or low incomes are no more at risk to reduce needed healthcare than anyone else.
The third report, out this month, looks at the effect of high-deductible plans on spending for an episode of care—the set of services required to manage a specific medical condition over a certain period of time. The good news from this study is that people always look for ways to conserve their healthcare dollars. The bad news is that, once again, one of the ways they save is by avoiding preventive care.
The episode of care for a broken wrist includes the ER, x-rays, doctors, and rehabilitation services. The researchers discovered that once care is initiated—the ER visit for that broken wrist, for instance—patients still have some control over how much they spend on healthcare services and they still find ways to save money on that episode of care.
How? Amelia Haviland, the study’s lead author and a senior statistician at RAND, explains that patients trim costs in three ways: they use fewer name-brand drugs, see fewer specialists, and limit their hospital stays.
“Unfortunately,” said Haviland in a telephone interview, “that only happened about one-third of the time. Usually patients achieved a savings during an episode of care by receiving less care.” So, in the case of that broken wrist, maybe a patient would go for five sessions of physical therapy instead of 10.