ArticleJAMA network open2020
Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes.
Article in JAMA network open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Impact of High Deductible Health Plans on Diabetes Care Quality and Outcomes: Systematic Review.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2021Pooled it
- High-Deductible Health Plan Enrollment and Buprenorphine Dispensing.JAMA network open · 2026Article
- Risk of Incident Cardiovascular Events Following Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy: A Claims-based Retrospective Cohort Study.Annals of surgery · 2026Article
- High-Deductible Health Plans and Receipt of Guideline-Concordant Care for Adults With Chronic Illness.JAMA network open · 2025Article
- Changes in Healthcare Spending Attributable to High Deductible Health Plan Offer Among Enrollees with Comorbid Substance Use Disorder and Cardiovascular Disease.Journal of general internal medicine · 2024Article
- Enrollment in High-Deductible Health Plans and Incident Diabetes Complications.JAMA network open · 2024Article
- Association of High-Deductible Health Plans With Health Care Use and Costs for Patients With Cardiovascular Disease.Journal of the American Heart Association · 2023Article
- Evaluation of High-Deductible Health Plans and Acute Glycemic Complications Among Adults With Diabetes.JAMA network open · 2023Article
- Assessment of the Social Security Administration Death Master File for Comparative Analysis Studies of Peripheral Vascular Devices.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Diabetes Microvascular Disease Diagnosis and Treatment After High-Deductible Health Plan Enrollment.Diabetes care · 2022Article
- Impact of High-Deductible Health Plans on Emergency Department Patients With Nonspecific Chest Pain and Their Subsequent Care.Circulation · 2021Article
- High-Deductible Health Plans and Emergency Care for Chest Pain: To Go or Not to Go.Circulation · 2021Article
- Health Care Payers COVID-19 Impact Assessment: Lessons Learned and Compelling Needs.NAM perspectives · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
Importance: Most people with commercial health insurance in the US have high-deductible plans, but the association of such plans with major health outcomes is unknown. Objective: To describe the association between enrollment in high-deductible health plans and the risk of major adverse cardiovascular outcomes. Design, Setting, and Participants: This cohort study examined matched groups before and after an insurance design change. Data were from a large national commercial (and Medicare Advantage) health insurance claims data set that included members enrolled between January 1, 2003, and December 31, 2014. The study group included 156 962 individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (≤$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans with typical value-based features after an employer-mandated switch. The matched control group included 1 467 758 individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans. Data were analyzed from December 2017 to March 2020. Exposures: Employer-mandated transition to a high-deductible health plan. Main Outcomes and Measures: Time to first major adverse cardiovascular event defined as myocardial infarction or stroke. Results: The study group included 156 962 individuals and the control group included 1 467 758 individuals; the mean age of members was 53 years (SD: high-deductible group, 6.7 years; control group, 6.9 years), 47% were female, and approximately 48% lived in low-income neighborhoods. First major adverse cardiovascular events among high-deductible health plan members did not differ relative to controls at follow-up vs baseline (adjusted hazard ratio, 1.00; 95% CI, 0.89-1.13). Findings were similar among subgroups with diabetes (adjusted hazard ratio, 0.93; 95% CI, 0.75-1.16) and with other cardiovascular risk factors (adjusted hazard ratio, 0.93; 95% CI, 0.81-1.07). Conclusions and Relevance: Mandated enrollment in high-deductible health plans with typical value-based features was not associated with increased risk of major adverse cardiovascular events.
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