The Truth About High Deductible Health Plans: The Unintended Consequences In The Name Of Cost Containment

In the pursuit of cost containment, High Deductible Health Plans (HDHPs) emerged in the early 2000s, presenting a paradigm shift in how employers and consultants approached healthcare for the following 15+ years. The prevailing notion was that by making members "better consumers" of healthcare services, their “consumerism” would reduce the cost of care to the health plan.

According to the Morgan Health January 2024 “Health Disparities in Employer Sponsored Insurance” all employees with an income of less than $150,000 “were significantly less likely to have a usual source of care.” More so “every income group below $150,000 reported significantly higher financial barriers to care than the highest income group, including difficulty paying medical bills, delaying care because of cost, and not adhering to medications as prescribed due to cost.”  

An examination of the last decade reveals an alarming truth: HDHP's are creating an increased burden on the members. According to the Kaiser Family Foundation (KFF, 2023), deductibles have surged by 53% in the last ten years. While this may offer a short-term cost reduction for employers, it poses serious cost barriers to care and creates a long-term impact on employees and their families through deferred care and non-adherence to prescribed medications, which in turn creates a higher financial burden on a company’s through uncontrolled chronic conditions.

The Trends:

1.   High-Cost Claimants Surge: The rise in deductibles has coincided with a notable increase in high-cost claimants. Non-adherence to medicines, not having a usual source of care, and the cost burden of medical care and pharmacy coinsurance are major factors.

2.   Emergency Room Visits Soar: Emergency room visits continue to rise.This suggests a trend of delayed or avoided care, fueled by the fear of unaffordable deductibles.

3.   Uncontrolled Chronic Conditions: A disturbing surge in uncontrolled chronic conditions is evident in the data, employee health is getting worse not better. The root cause? An unhealthy population hesitating to utilize their benefits due to the financial barrier presented by high deductibles.

Contrary to the notion that reducing deductibles is financially burdensome for employers, the right solutions create a win-win scenario. Removing barriers to care is the first step in creating equity in your healthcare plan, but that alone it isn’t enough.  Simplified access to care with dedicated clinicians improve employee and dependent health outcomes, manage employees chronic conditions and by doing so enhances productivity—these are the real outcomes when barriers to healthcare are dismantled.  In the quest for cost containment, we must not lose sight of the human impact. High Deductible Health Plans, in their current form, contribute to a healthcare system marred by delayed care, financial fear, and shorter life expectancy.

Employers have the power to change this narrative.It's time to prioritize the well-being of your employees, ensuring that accessing healthcare is easy, affordable, and does not result in a financial dilemma. If you share our passion for removing barriers to healthcare for your employees let’s collaborate. Reach out to Results@Genesys.Health, and together, we can redefine the future of healthcare for everyone.

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