High-deductible Health Plans May Negatively Impact Patients with Diabetes, New Review Suggests

Low-income patients with diabetes enrolled in high-deductible health plans used less preventive and primary care services and more emergency visits, suggests new review.

High-deductible health plans (HDHPs) negatively impact low-income patients with diabetes by leading them to use less preventive and primary care services and more emergency department visits, according to a new review.

Authors of the review published online August 13, 2021, in the journal Primary Care Diabetes aimed to systematically pool the medical and non-medical impacts of HDHPs on patients with diabetes.

Researchers searched medical publication databases (eg, PubMed, Scopus) to identify relevant, peer-reviewed quantitative studies. Out of over 140 results, 11 studies met the eligibility criteria and were included in the analysis.

The researchers found that patients with diabetes who were enrolled in HDHPs were less likely to adhere to treatment and prescription refills, compared to patients with diabetes enrolled in low-deductible health plans.

Also, patients with diabetes enrolled in HDHPs were found to utilize fewer health care services and medications and were more likely to have acute emergency department visits than their counterparts enrolled in low-deductible health plans.

The results on overall health care costs and the final health outcome were unclear, however, added researchers.

“The socioeconomic characteristics of patients must be considered when developing HDHP policies, and adjustments should be made to HDHPs accordingly,” concluded authors led by Ahmad Khanijahani, PhD, MS, assistant professor, Department of Health Administration and Public Health, Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania.