ArticleThe American journal of managed care2022
The impact of HDHPs on service use and spending for substance use disorders.
Article in The American journal of managed care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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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.
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Who cites it
8 citing papers in PubMed.
- Opioid Use Disorder Care Presentations After High-deductible Health Plan Enrollment.Journal of addiction medicine · 2026Article
- Payment-related barriers to medications for opioid use disorder: A critical review of the literature and real-world application.Journal of substance use and addiction treatment · 2024Review
- 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
- Deductible imputation in administrative medical claims datasets.Health services research · 2024Article
- US payment policy for medications to treat opioid use disorder: landscape and opportunities.Health affairs scholar · 2024Article
- Impact of High Deductible Health Plans on U.S. Adults With Chronic Pain.American journal of preventive medicine · 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
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesAlthough high-deductible health plans (HDHPs) reduce health care spending, higher deductibles may lead to forgone care. Our goal was to determine the effects of HDHPs on the use of and spending on substance use disorder (SUD) services. STUDY
designWe used difference-in-differences models to compare service use and spending for treating SUD among enrollees who were newly offered an HDHP relative to enrollees offered only traditional plan options throughout the study period.
methodsWe used deidentified commercial claims data from OptumLabs (2007-2017) to identify a sample of 28,717,236 person-years (2.2% with a diagnosed SUD). The main independent measure was an indicator for being offered an HDHP. The main dependent measures were the probability of (and spending associated with) using SUD services and specific treatment types.
resultsEnrollees were 6.6% (P < .001) less likely to use SUD services after being offered an HDHP relative to the comparison group. Reductions were concentrated in inpatient, intermediate, and ambulatory care, as well as medication use. Being offered an HDHP was associated with a decrease of 21% (P < .001) on health plan spending and an increase of 14% (P < .01) on out-of-pocket spending.
conclusionsOffering an HDHP was associated with a reduction in SUD service use and a shift in spending from the plan to the enrollee. In the context of the US drug epidemic, these study findings highlight a concern that the movement toward HDHPs may be exacerbating undertreatment of SUD.
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