Harvard Medical School
180 Longwood Ave. Boston, MA 02115
NBER Working Papers and Publications
|March 2015||Do “Consumer-Directed” Health Plans Bend the Cost Curve Over Time?|
with Amelia M. Haviland, Matthew D. Eisenberg, Peter J. Huckfeldt, Neeraj Sood: w21031
“Consumer-Directed” Health Plans (CDHPs) combine high deductibles with personal medical accounts and are intended to reduce health care spending through greater patient cost sharing. Prior research shows that CDHPs reduce spending in the first year. However, there is little research on the impact of CDHPs over the longer term. We add to this literature by using data from 13 million individuals in 54 large US firms to estimate the effects of a firm offering CDHPs on health care spending up to three years post offer. We use a difference-in-differences analysis and to further strengthen identification, we balance observables within firm, over time by developing weights through a machine learning algorithm. We find that spending is reduced for those in firms offering CDHPs in all three years ...
Published: Amelia M. Haviland & Matthew D. Eisenberg & Ateev Mehrotra & Peter J. Huckfeldt & Neeraj Sood, 2016. "Do “Consumer-Directed” health plans bend the cost curve over time?," Journal of Health Economics, vol 46, pages 33-51. citation courtesy of
|February 2015||Patient Responses to Incentives in Consumer-directed Health Plans: Evidence from Pharmaceuticals|
with Peter J. Huckfeldt, Amelia Haviland, Zachary Wagner, Neeraj Sood: w20927
Prior studies suggest that consumer-directed health plans (CDHPs) -characterized by high deductibles and health care accounts- reduce health costs, but there is concern that enrollees indiscriminately reduce use of low-value services (e.g., unnecessary emergency department use) and high-value services (e.g., preventive care). We investigate how CDHP enrollees change use of pharmaceuticals for chronic diseases. We compare two large firms where nearly all employees were switched to CDHPs to firms with conventional health insurance plans. In the first firm’s CDHP, pharmaceuticals were subject to the deductible, while in the second firm pharmaceuticals were exempt. Employees in the first firm shifted the timing of drug purchases to periods with lower cost sharing and were more likely to use lo...