Higher deductibles mean less imaging use

Patients who have high-deductible health insurance plans undergo fewer imaging tests, according to a study published in Medical Care.

Researchers from Boston University used 2010 data from an insurance database of more than 21 million adults to compare use rates and costs of imaging for patients with and without high-deductible plans. Plans with an annual deductible of $1,200 for individuals and $2,400 for families were considered high-deductible.

When lead author Sarah Zheng and colleagues controlled for age, sex, geographic location, and health status, they found that patients enrolled in high-deductible plans had 7.5% fewer imaging studies than those in other plans (Medical Care, February 2016, Vol. 54:2, pp. 110-117).

However, the researchers could not determine whether the reduced imaging use associated with high-deductible insurance was of high or low value -- an important distinction for patient outcomes. This raises the concern that high-deductible health plans are a "blunt instrument" that reduces all diagnostic imaging, rather than helping physicians and patients choose high-value imaging, they wrote.

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