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The Honolulu Advertiser
Posted on: Sunday, December 11, 2005

High-deduct health plan users cut corners

Bloomberg News Service

WASHINGTON — Consumers enrolled in health-insurance plans with higher out-of-pocket costs are more likely to ask their doctor for cheaper generic medicines, a U.S. survey found.

Forty-four percent of patients with higher deductibles said they sought cheaper drugs, compared with 27 percent of beneficiaries with more comprehensive coverage, according to the survey released last week by the nonpartisan Employee Benefits Research Institute and the Commonwealth Fund. Patients with higher out-of-pocket costs also were more likely to check prices of drugs and services, and to use fewer services.

The findings show health plans need to offer more information on the cost and quality of care so patients who pay more of the own expenses themselves don't reject needed treatment, the researchers said. Less than 20 percent of high- deductible plans offered such information, the survey found.

"We're a long way away from having the information available to make these plans work well," said Sara Collins, a senior program officer at the Commonwealth Fund, a private foundation.

The researchers defined high deductibles as $1,000 or more for an individual and $2,000 or more for a family. The survey of 1,204 U.S. residents ages 21 to 64 was conducted from Sept. 28 to Oct. 19 over the Internet.

Doctors and hospitals aren't likely to submit information on their prices and performance unless there is a great demand, said Scott Keyes of Watson Wyatt & Co. in Stamford, Conn., a benefits consulting firm. As higher-cost plans become more common, more information will become available, he said.

"You have to make people ask for it in order to get it," Keyes said. "If you were selling plenty of cars without disclosing the price, why would you ever give that up?"

That demand is likely to grow as more employers consider offering high-deductible plans and health savings accounts to reduce their medical costs. The accounts allow consumers to save money tax-free to cover their own medical expenses, as long as they are enrolled in high-deductible plans.