If you’re an employer considering a required transition to a High-Deductible Health Plan (HDHP) for your employees, you may want to think again.

Low upfront costs have made HDHPs popular among employers looking to save money as healthcare becomes increasingly expensive for companies and employees alike, but a recent study published by the Journal of American Medical Association Open Network offers a cautionary tale to employers enchanted by the potential cost savings.

High-Deductibles, Significant Complications

In a cohort study of more than 245,000 US adults with diabetes enrolled in employer-sponsored health plans who were required to transition to a HDHP, the researchers identified increased odds of those impacted experiencing microvascular and macrovascular complications from diabetes.

Compared to adults with diabetes who were able to stay enrolled in a non-HDHP, the involuntary switch of adults with diabetes from a non-HDHP to a HDHP – involuntary because the employer did not offer a non-HDHP that year – correlated with significant increases in the rates of all diabetes complications, ranging from an 11% increase in the risk of heart attack, 253% increase in the risk of end stage kidney disease, higher rates of hyperglycemia and hypoglycemia, and more.

“These findings reinforce the potential harm associated with HDHPs for people with diabetes and the importance of affordable and accessible chronic disease management, which is hindered by high out-of-pocket costs incurred by HDHPs,” concluded the study’s authors.

While HDHPs can cut costs for employers and employees by offering lower premiums, the high out-of-pocket costs may impede access to care and increase the risk of adverse health outcomes for people living with diabetes.

Offer More Than a HDHP

When considering this study, it’s important to acknowledge what we don’t know. Were the individuals in the study facing struggles managing their health prior to the change in plan offerings? Were there any other differences in plan design for those impacted that could have contributed to whether they could seek care? Though these questions aren’t answered by the research, the conclusion still poses an important challenge for employers evaluating a required switch to a HDHP.

We understand that employers are facing an uphill battle as healthcare costs skyrocket and comprehensive health plans play a crucial role in talent recruitment and retention. Improving your employee benefits doesn’t happen overnight, but you need to start somewhere.

So, how can your company navigate these uncharted waters? Here’s what we recommend.

• Offer non-HDHP options: Some employees will gravitate towards the benefits of the HDHP, but it’s important to provide options for those who can best seek care from a PPO or other health plan.
• Ensure affordability in both premium and deductible for non-HDHP options: When your employees and their families need help, being able to afford care can make or break their choice to seek it.
• Don’t ignore health literacy and cultural norms: Healthcare can be complicated even for those of us who know the industry. Make sure you’re educating plan members and identifying ways to bridge cultural differences to ensure all employees understand their options.
• Offer a chronic disease management program: Chronic diseases aren’t only a huge driver of the country’s annual healthcare costs – they are the leading causes of death and disability in the US. Offering a chronic disease management program at no cost to members can help them manage care and impact behaviors. Communicate to your employees about the program frequently and effectively to ensure engagement.

Work With Employee Benefits Experts Who Understand Your Needs

Every company is different, and we’re here to help create unique solutions designed for your needs. The team at Holmes Murphy can evaluate your specific considerations with budget, plan design, and clinical wellbeing options.

Reach out today and let’s get started!