The Impact of HDHPs on Service Use and Spending for Substance Use Disorders

OBJECTIVE: While high-deductible health plans (HDHPs) reduce healthcare spending, higher deductibles may lead to foregone care. Our goal was to determine the effects of HDHPs on the use of and spending on SUD services. STUDY DESIGN: We used difference-in-differences models to compare service use and spending for treating SUD among enrollees who were newly offered a HDHP relative to enrollees only offered traditional plan options throughout the study period. METHODS: We used de-identified commercial claims data from OptumLabs(®) (2007-2017) to identify a sample of 28,717,236 person-years (2.2% with a diagnosed SUD). The main independent measure was an indicator for being offered a HDHP. The main dependent measures were the probability of (and spending associated with) using SUD services and specific treatment types. RESULTS: Enrollees were 6.6% (p