- Direct usage of medical services such as preventable ER visits and hospitalization
- Illness-related presenteeism
- Cost of temporary workers
- Overtime costs
The growing cost burden of HDHPsBy 2030, unmanaged chronic diseases such as diabetes, high blood pressure, heart disease, asthma and depression are projected to cost an estimated $2 trillion in direct medical costs, as well as an additional $794 billion in indirect costs like lost employee productivity. While the combination of health savings accounts (HSAs) and HDHPs was supposed to help reduce costs by encouraging consumers to take more ownership of their own health care, deductibles on important preventative drug therapies cause plan members to skip needed medications. This has been shown to lead to much more expensive conditions later, including blindness, amputation, heart attacks and strokes. Conversely, workers and covered family members are significantly more likely to be medication-compliant when these drugs are exempt from their health plan’s deductible — and therefore less likely to be hospitalized, become disabled or need more expensive medical treatment. Among HDHP plans that expanded pre-deductible coverage to 116 drug classes used to manage expensive long-term, chronic medical conditions, the cost of these drugs was almost entirely offset by reduced health care utilization. Among the study’s highlights:
- When plan sponsors allowed plan beneficiaries to access these medications with zero out-of-pocket cost-sharing (e.g., no deductible and no coinsurance), the net impact on premiums was an increase of 4.7%.
- When employer HDHP plans allowed plan members to access these medications with a coinsurance charge, but no deductible, the direct net effect on premiums was an increase of only 1.3%.