Evidence map›Paper›PMID 37187443›Full record

ArticleAmerican journal of preventive medicine2023

Impact of High Deductible Health Plans on U.S. Adults With Chronic Pain.

Alene Kennedy-Hendricks, Julia C P Eddelbuettel, Mark C Bicket, Mark K Meiselbach, Mara A G Hollander, Alisa B Busch, Haiden A Huskamp, Elizabeth A Stuart, Colleen L Barry, Matthew D Eisenberg

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

Article in American journal of preventive medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.9field-weighted citation impact, top 7% 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

5 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Pain Research and Treatment: Policy Implications.Policy insights from the behavioral and brain sciences · 2024
    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

10 authors at 5 institutions in 1 country.

Alene Kennedy-HendricksDepartment of Health Policy and Management, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Johns Hopkins Center for Mental Health and Addiction Policy, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: alene@jhu.edu.
Julia C P EddelbuettelDepartment of Health Policy and Management, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Mark C BicketDepartment of Anesthesiology and Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Mark K MeiselbachDepartment of Health Policy and Management, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Mara A G HollanderDepartment of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina.
Alisa B BuschMcLean Hospital, Belmont, Massachusetts; Department of Health Care Policy, Harvard Medical School, Cambridge, Massachusetts.
Haiden A HuskampDepartment of Health Care Policy, Harvard Medical School, Cambridge, Massachusetts.
Elizabeth A StuartDepartment of Health Policy and Management, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Johns Hopkins Center for Mental Health and Addiction Policy, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Colleen L BarryCornell Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, New York.
Matthew D EisenbergDepartment of Health Policy and Management, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Johns Hopkins Center for Mental Health and Addiction Policy, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Matthew Eisenberg's, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Johns Hopkins University · USHarvard University · USCornell University · USUniversity of Michigan · USUniversity of North Carolina at Charlotte · US

Funding

Research Support CoreP30DA035772 · NIDA · BRANDEIS UNIVERSITY · PI Haiden A Huskamp, SHARON REIF · 2015 to 2026
$11.3M
Consumer-Directed Health Plans and Substance Use Disorder TreatmentR01DA044201 · NIDA · JOHNS HOPKINS UNIVERSITY · PI BARRY, COLLEEN L, EISENBERG, MATTHEW · 2018 to 2021
$2.9M
Mental Health Services and Systems Training ProgramT32MH109436 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Matthew Eisenberg, Elizabeth A. Stuart · 2017 to 2026
$1.7M
NIDA NIH HHS P30 DA035772NIDA NIH HHS R01 DA044201NIMH NIH HHS T32 MH109436
6 · The paper itself

Abstract

introductionChronic pain affects an estimated 20% of U.S. adults. Because high-deductible health plans have captured a growing share of the commercial insurance market, it is unknown how high-deductible health plans impact care for chronic pain.

methodsUsing 2007-2017 claims data from a large national commercial insurer, statistical analyses conducted in 2022-2023 estimated changes in enrollee outcomes before and after their firm began offering a high-deductible health plan compared with changes in outcomes in a comparison group of enrollees at firms never offering a high-deductible health plan. The sample included 757,530 commercially insured adults aged 18-64 years with headache, low back pain, arthritis, neuropathic pain, or fibromyalgia. Outcomes, measured at the enrollee year level, included the probability of receiving any chronic pain treatment, nonpharmacologic pain treatment, and opioid and nonopioid prescriptions; the number of nonpharmacologic pain treatment days; number and days' supply of opioid and nonopioid prescriptions; and total annual spending and out-of-pocket spending.

resultsHigh-deductible health plan offer was associated with a 1.2 percentage point reduction (95% CI= -1.8, -0.5) in the probability of any chronic pain treatment and an $11 increase (95% CI=$6, $15) in annual out-of-pocket spending on chronic pain treatments among those with any use, representing a 16% increase in average annual out-of-pocket spending over the pre-high deductible health plan offer annual average. Results were driven by changes in nonpharmacologic treatment use.

conclusionsBy reducing the use of nonpharmacologic chronic pain treatments and marginally increasing out-of-pocket costs among those using these services, high-deductible health plans may discourage more holistic, integrated approaches to caring for patients with chronic pain conditions.

Indexed as

Chronic PainDeductibles and CoinsuranceAdultAnalgesics, OpioidCosts and Cost AnalysisHealth ExpendituresHumansAnalgesics, Opioid

Identifiers

PMID37187443
PMCPMC10592566
OpenAlexW4376288324

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.