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J Occup Environ Med. 2009 May;51(5):594-603. doi: 10.1097/JOM.0b013e31819b8c1c.

Consumer-driven health plans: impact on utilization and expenditures for chronic disease sufferers.

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1
School of Pharmacy, University of Colorado at Denver, Aurora, Colo 80045, USA. kavita.nair@ucdenver.edu

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.

PMID:
19369897
DOI:
10.1097/JOM.0b013e31819b8c1c
[Indexed for MEDLINE]
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