Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Doughnut-hole economics.

Meredith B Rosenthal1

  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA. mrosenth@hsph.harvard.edu

Health Affairs (Project Hope)
|November 13, 2004
PubMed
Summary

New Medicare drug benefits and consumer-directed health plans feature high deductibles, increasing patient financial risk. This design likely aims to provide broad, tangible benefits to many constituents.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Medicaid Expansion and Mortality Among Formerly Incarcerated Individuals.

JAMA health forum·2026
Same author

Primary Care Access and the Role of Telemedicine for Traditional Medicare Beneficiaries.

JAMA health forum·2026
Same author

Hospital-Medicare Advantage vertical integration and medical loss ratios.

Health affairs scholar·2026
Same author

Hospital-Medicare Advantage Vertical Consolidation, 1980 to 2024.

Medical care research and review : MCRR·2026
Same author

Test Ordering and Completion During Virtual vs In-Person Annual Visits.

JAMA network open·2026
Same author

Billing of Medicare's G2211 Longitudinal Care Code Among Traditional Medicare Beneficiaries.

JAMA·2026

Area of Science:

  • Health economics
  • Health insurance policy
  • Public health

Background:

  • Recent Medicare prescription drug benefit legislation and emerging consumer-directed health plan models.
  • Prevalence of 'doughnut-shaped' insurance coverage with deductibles positioned near average annual healthcare spending.

Purpose of the Study:

  • To analyze the implications of 'doughnut-shaped' health insurance coverage.
  • To explore the rationale behind the trend of high deductibles in health benefit designs.

Main Methods:

  • Comparative analysis of health insurance payout structures.
  • Examination of risk distribution in different deductible models (doughnut vs. first-dollar).
  • Assessment of healthcare spending distributions.

Main Results:

  • Doughnut-shaped policies increase enrollee financial risk compared to first-dollar deductible policies with similar expected payouts.
  • The placement of deductibles around mean annual spending exacerbates this risk due to skewed healthcare cost distributions.

Conclusions:

  • The observed trend in health benefit design, characterized by high deductibles, presents substantial financial risk to enrollees.
  • The most plausible explanation for this design trend is the strategic aim to distribute tangible benefits across a large number of constituents.

Related Experiment Videos