Somehow I missed this article in JAMA back in March. The authors examined emergency room use (the most expensive type of care) among those with high-deductible policies and those in a traditional HMO. According to the article, “High-deductible health plans have been promoted as a means of reducing overutilization but could also be related to worse outcomes if patients defer necessary care.” The objective of the study was to “determine the relationship between transition to a high-deductible health plan and emergency department use for low- and high-severity conditions and to examine changes in subsequent hospitalizations.”

The results were that repeat visits to the emergency room dropped significantly among those with high-deductible plans. There was also a small drop among referrals from the emergency room to hospitalization.

The article wasn’t fully able to explore how the difference affected health outcomes. However, the drop in repeat visits occurred heavily among the “low-severity” group. This suggests that people cut back on emergency room visits when emergency room visits are least necessary.

Gee, it seems that individuals are pretty good judges of their own health needs. Who knew?