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Related Experiment Videos

Making 'more skin in the game' work.

Merrill Goozner

    Modern Healthcare
    |November 15, 2018
    PubMed
    Summary

    Patient cost-sharing in health insurance can be effective, but high-deductible plans are not the solution. Many individuals with employer-sponsored or exchange-based health plans face significant out-of-pocket healthcare expenses.

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    Area of Science:

    • Health Economics
    • Public Health Policy

    Background:

    • A significant portion of the population is enrolled in health insurance plans with substantial patient cost-sharing.
    • High-deductible health plans (HDHPs) are prevalent in both employer-sponsored and individual insurance markets.
    • The concept of 'skin in the game' refers to increasing patient financial responsibility for healthcare services.

    Purpose of the Study:

    • To evaluate the effectiveness of patient cost-sharing mechanisms in health insurance.
    • To determine if high-deductible plans are a suitable method for increasing patient financial engagement.
    • To analyze the current landscape of health insurance deductibles.

    Main Methods:

    • Analysis of data on employer-sponsored health insurance enrollment.
    • Examination of plan structures available on health insurance exchanges (e.g., Obamacare).
    • Review of literature on patient cost-sharing and healthcare utilization.

    Main Results:

    • Nearly 30% of 150 million individuals with employer-based insurance have deductibles of $1,000 or more.
    • The majority of individual health plans offered on Obamacare exchanges feature high deductibles.
    • The effectiveness of 'skin in the game' strategies is questioned when implemented via high-deductible plans.

    Conclusions:

    • High-deductible health plans may not be the optimal approach for increasing patient financial responsibility.
    • Alternative strategies for patient cost-sharing should be explored.
    • The prevalence of high deductibles impacts a large segment of the insured population.

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