ArticlePsychiatric services (Washington, D.C.)2022
Effects of High-Deductible Health Plans on Enrollees With Mental Health Conditions With and Without Substance Use Disorders.
Article in Psychiatric services (Washington, D.C.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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
11 citing papers in PubMed.
- Mental Health Utilization Gap by Insurance Type Among US Adults With Chronic Pain.JAMA health forum · 2026Article
- 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
- Extended Postpartum Medicaid In Colorado Associated With Increased Treatment For Perinatal Mood And Anxiety Disorders.Health affairs (Project Hope) · 2024Article
- Prescription Drug Dispensing and Patient Costs After Implementation of a No Behavioral Health Cost-Sharing Law.JAMA health forum · 2024Article
- Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans.Plastic and reconstructive surgery. Global open · 2024Article
- PERSPECTIVE: A Path to Value-Based Insurance Design for Mental Health Services.The journal of mental health policy and economics · 2024Article
- Choice of high-deductible health plans among enrollees with a substance use disorder.Journal of substance use and addiction treatment · 2023Article
- Do High-Deductible Health Plans Incentivize Changing the Timing of Substance Use Disorder Treatment?Medical care research and review : MCRR · 2023Article
- High-Deductible Health Plans' Impact on Mental Health and Substance Use Disorder Treatments-Balancing Cost and Care.JAMA psychiatry · 2023Article
- Plan Selection, Enrollee Risk, and Health Spending on the Patient Protection and Affordable Care Act Individual Marketplaces, 2019.JAMA network open · 2023Article
- High deductible health plans and spending among families with a substance use disorder.Drug and alcohol dependence · 2022Article
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.
Funding
Abstract
objectiveHigh-deductible health plans (HDHPs) are increasingly common in the U.S. health insurance market and are intended to reduce the use of low-value services, but evidence suggests that HDHP enrollees also reduce the use of high-value services. This study examined the effects of HDHPs on enrollees with mental health conditions, a population with high levels of unmet treatment need, often because of financial barriers. Enrollees with a co-occurring substance use disorder have greater treatment needs and unique barriers to care, perhaps changing their response to an HDHP.
methodsCommercial health insurance claims data in a difference-in-differences design was used to evaluate the effect of an employer's offer of an HDHP on 6,627,128 enrollee-years among enrollees with mental health conditions, stratified by having a co-occurring substance use disorder or not.
resultsAmong enrollees without a co-occurring substance use disorder, an HDHP offer was associated with a 4.8% (95% confidence interval [CI]=2.4%-7.2%) reduction in overall spending on mental health care, despite an 11.3% (95% CI=1.0%-21.6%) increase in spending on mental health-related emergency department visits. Among enrollees with a co-occurring substance use disorder, no significant changes attributable to an HDHP offer were found in most categories of spending on combined mental health and substance use disorder care, apart from a 4.5% (95% CI=1.9%-7.2%) reduction in spending on psychotropic medications.
conclusionsHDHPs may reduce use of necessary care among enrollees with mental health conditions, which could exacerbate undertreatment in this population and result in adverse health outcomes.
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What OpenQuestion holds
Registered trials
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