Studying more than 800,000 families from across the United States, RAND researchers found that when people shifted into health insurance plans with high deductibles, their health spending dropped an average of 14 percent when compared to families in health plans with lower deductibles:
“We discovered that costs go down dramatically during the first year people are enrolled in high-deductible health plans, as long as the deductible is at least $1,000 per person,” said Amelia M. Haviland, a study co-author.
But as families reduced their medical spending, they eliminated some care that is clearly beneficial. Among families in traditional health plans, childhood vaccination increased increase slightly by 2.7 percent. Among families in high-deductible health plans, childhood immunizations fell by 3.6 percent. Mammography, cervical cancer and colorectal cancer screening rates were also slightly lower — just over two percentage points— among those with high-deductible health plans compared to families in traditional health plans.
RAND concedes that it doesn’t know why these results occurred:
The drop in preventive care happened even though the high-deductible plans in the study waived the need to pay a deductible when receiving such care. This suggests that enrollees in high-deductible plans either did not understand this part of their policy or some other factor discouraged them from getting preventive care.