Helping Patients With Chronic Conditions Overcome Challenges of High-Deductible Health Plans: Mixed Methods Study.

Area of Science:

• Health Economics
• Behavioral Science
• Health Services Research

Background:

• High-deductible health plans (HDHPs) are increasingly common, posing financial challenges for enrollees, especially those with chronic conditions.
• Enrollees often delay or forgo necessary care due to high out-of-pocket costs.
• Cost-conscious strategies like provider cost discussions and price comparisons are underutilized by HDHP enrollees.

Purpose of the Study:

• To assess preferences for a novel behavioral intervention among HDHP enrollees with chronic conditions.
• To identify desired features, content, and delivery methods for an intervention supporting cost-conscious healthcare seeking.

Main Methods:

• Exploratory sequential mixed methods study involving 20 semistructured interviews and a national internet survey of 432 HDHP enrollees with chronic conditions (diabetes, hypertension, CAD, COPD, asthma).
• Assessed healthcare experiences, barriers to cost-conscious strategies, and preferences for intervention content, modality, and frequency.

Main Results:

• 55% of interviewees reported barriers to cost-conscious strategies, citing lack of information and time concerns.
• 90% found strategies like discussing costs, saving, and price comparison helpful.
• 85% expressed interest in a website/app for price comparison; survey participants favored price/quality comparison, provider cost discussions, and saving for care via web/email interventions used infrequently.

Conclusions:

• Cost-conscious strategies can alleviate financial burdens for HDHP enrollees with chronic conditions.
• Web-based interventions are preferred for delivering support.
• Interventions should focus on price comparison and navigating HDHPs to manage out-of-pocket expenses effectively.