Cover: Impact of Consumer-Directed Health Plans on Low-Value Healthcare

Impact of Consumer-Directed Health Plans on Low-Value Healthcare

Published in: The American Journal of Managed Care, Volume 23, Issue 12, pages 741–748 (December 2017)

Posted on Feb 12, 2021

by Rachel O. Reid, Brendan Rabideau, Neeraj Sood


To assess the impact of consumer-directed health plan (CDHP) enrollment on low-value healthcare spending.

Study Design

We performed a quasi-experimental analysis using insurance claims data from 376,091 patients aged 18 to 63 years continuously enrolled in a plan from a large national commercial insurer from 2011 to 2013. We measured spending on 26 low-value healthcare services that offer unclear or no clinical benefit.


Employing a difference-in-differences approach, we compared the change in spending on low-value services for patients switching from a traditional health plan to a CDHP with the change in spending on low-value services for matched patients remaining in a traditional plan.


Switching to a CDHP was associated with a $231.60 reduction in annual outpatient spending (95% CI, –$341.65 to –$121.53); however, no significant reductions were observed in annual spending on the 26 low-value services (–$3.64; 95% CI, –$9.60 to $2.31) or on these low-value services relative to overall outpatient spending (–$7.86 per $10,000 in outpatient spending; 95% CI, –$18.43 to $2.72). Similarly, a small reduction was noted for low-value spending on imaging (–$1.76; 95% CI, –$3.39 to –$0.14), but not relative to overall imaging spending, and no significant reductions were noted in low-value laboratory spending.


CDHPs in their current form may represent too blunt an instrument to specifically curtail low-value healthcare spending.

Research conducted by

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