Skip Navigation LinksHome > May 2009 - Volume 51 - Issue 5 > Consumer-Driven Health Plans: Impact on Utilization and Expe...
Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e31819b8c1c
Original Articles

Consumer-Driven Health Plans: Impact on Utilization and Expenditures for Chronic Disease Sufferers

Nair, Kavita V. PhD; Park, Jinhee CPhil, MA, MS; Wolfe, Pamela MS; Saseen, Joseph J. PharmD, FCCP, BCPS; Allen, Richard Read MS; Ganguly, Rahul PhD

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Abstract

Objectives: The impact of consumer-driven health plans (CDHPs) on utilization and expenditures for members with chronic diseases.

Methods: Analyzed claims data from a national employer who switched from a preferred provider organization (PPO) plan to offering only CDHPs in 2005. A matched comparison group of PPO members was used. Analysis was conducted using generalized estimating equations for repeated measures.

Results: Compared with the PPO group, the CDHP group had lower: outpatient visits (−36% vs −22%), laboratory services (−34.3% vs −19%), emergency room (odds ratio [OR]: 0.1 vs 0.6), and inpatient visits (OR: 0.35 vs 0.68), and medication adherence (OR: 0.7 vs 1.0). Reductions in health care expenditures were not statistically different between the groups (−28% vs −15%, P = 0.5).

Conclusions: Switching to a CDHP resulted in lower utilization and adherence. Potential underutilization of necessary services should be addressed in future research.

©2009The American College of Occupational and Environmental Medicine

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