By Neeraj Sood, Zachary Wagner, Peter Huckfeldt, Amelia M. Haviland
Forum for Health Economics and Policy, Published online March 20, 2013
Abstract
We use health insurance claims data from 63 large employers to estimate the extent of price shopping for nine common outpatient services in consumer-directed health plans (CDHPs) compared to traditional health plans. The main measures of price shopping include (1) the total price paid on the claim, (2) the share of claims from low- and high-cost providers, and (3) the savings from price shopping relative to choosing prices randomly. All analyses control for individual and zip code level demographics and plan characteristics. We also estimate differences in price shopping within CDHPs depending on expected health care costs and whether the service was bought before or after reaching the deductible. For eight out of nine services analyzed, prices paid by CDHP and traditional plan enrollees did not differ significantly; CDHP enrollees paid 2.3% less for office visits. Similarly, office visits was the only service where CDHP enrollment resulted in a significantly larger share of claims from low-cost providers and greater savings from price shopping relative to traditional plans. There was also no evidence that, within CDHP plans, consumers with lower expected medical expenses exhibited more price shopping or that consumers exhibited more price shopping before reaching the deductible.
The full article can be downloaded at this link (19 pages):
http://www.degruyter.com/view/j/fhep.ahead-of-print/fhep-2012-0028/fhep-2012-0028.xml
Comment:
By Don McCanne, M.D.
High-deductible consumer-directed health plans are designed to make health care consumers better price shoppers, especially when they are spending their own money below the deductible. Guess what. Health care consumers do not shop prices to any measurable extent.
We should quite wasting our time looking for magical solutions to controlling health care costs and move on with health care reform that has been proven to work – a single payer national health program, an improved Medicare for all.
