Evidence map›Paper›PMID 36370532›Full record

ArticleDrug and alcohol dependence2022

High deductible health plans and spending among families with a substance use disorder.

Mark K Meiselbach, Alene Kennedy-Hendricks, Cameron Schilling, Alisa B Busch, Haiden A Huskamp, Elizabeth A Stuart, Mara A G Hollander, Colleen L Barry, Matthew D Eisenberg

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Mark K MeiselbachDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; OptumLabs Visiting Fellow, USA. Electronic address: mark.meiselbach@jhu.edu.
Alene Kennedy-HendricksDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Cameron SchillingDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Alisa B BuschDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; McLean Hospital, Boston, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Haiden A HuskampDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Elizabeth A StuartDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Mara A G HollanderDepartment of Public Health Sciences, University of North Carolina - Charlotte, Charlotte, NC, USA.
Colleen L BarryCornell Jeb E. Brooks School of Public Policy, Ithaca, NY, USA.
Matthew D EisenbergDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins Carey Business School, Baltimore, MD, USA.
Johns Hopkins University · USHarvard University · USCornell University · USOptum (United States) · USUniversity of North Carolina at Charlotte · US

Funding

Mental Health Services and Systems Training ProgramT32MH109436 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Matthew Eisenberg, Elizabeth A. Stuart · 2017 to 2026
$1.7M
NIMH NIH HHS T32 MH109436
6 · The paper itself

Abstract

backgroundThe United States faces an ongoing drug crisis, worsened by the undertreatment of substance use disorders (SUDs). Family enrollment in high deductible health plans (HDHPs) and the resulting increased cost exposure could exacerbate the undertreatment of SUD. This study characterized the distribution of health care spending within families where a member has a SUD and estimated the association between HDHPs and family health care spending.

methodsUsing commercial claims and enrollment data from OptumLabs (2007-2017), we identified a treatment group of enrollees whose employers began offering an HDHP and comparison group whose employers never offered an HDHP. We used a difference-in-differences analysis that compared health care spending in families at firms that did vs. did not offer an HDHP before and after the HDHP offer. All models were adjusted for employer and year fixed effects, as well as family demographics, size, and chronic conditions.

resultsOur sample was comprised of 317,353 family-years. Family members with a SUD, on average, contributed an outsized proportion of total family health care expenditures (56.9% in a family of three). Offering a family HDHP was associated with a 6.1% reduction (95% confidence interval [CI]: 9.7-2.6%) in the probability of families having any SUD-related expenditures. The HDHP offer was associated with a $1546 reduction in family total expenditures and a $1185 reduction for the individual with SUD (95% CI: -2272 to -821 and -1845 to -525, respectively).

conclusionsThe increased prevalence of family enrollment in HDHPs may further the existing issue of undertreatment of SUDs.

Indexed as

Deductibles and CoinsuranceSubstance-Related DisordersChronic DiseaseFamily HealthHealth ExpendituresHumansUnited StatesDeductiblesFamily coverageHealth care spendingHigh-deductible health plansSubstance use disorders

Identifiers

PMID36370532
PMCPMC9976712
OpenAlexW4308159026

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.