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1.

Consumer-Directed Health Plans (CDHPs)

CDHPs raise enrollees’ financial stake in making informed choices about the cost of their

care. However, the demand for these plans is largely unevaluated, except in the context of

employee choice among similar alternatives. In addition, it is unclear how tax-favored programs

such as flexible spending accounts or health savings accounts (HSAs) might affect the demand

for these plans: a relatively small share of the population with private insurance has a high-

deductible health plan that would qualify for an HSA, and only a minority of these plans actually

include an HSA (Claxton et al. 2005). Nevertheless, the consumer directed health plans has

attracted attention from policymakers as a potential model for significantly expanding coverage

while

controlling

cost.

A

better

understanding

of

the

factors

that

influence

demand

for

CDHPs—as well as the use of health care services once enrolled—is essential to understanding

their potential to provide adequate and affordable coverage more broadly.

2.

Medicare Services

With Medicare’s beneficiary population growing faster than the tax-base that supports the

program, Medicare’s long-term financing presents an immense challenge. In an effort to address

this challenge, Medicare’s benefit design may change significantly in the long-term and also in

the short-term, as Medicare Advantage plans adjust benefits to constrain cost. However, the

research literature offers very limited basis for anticipating the effects of changes in Medicare’s

benefit design, including the introduction of Part D. Even the few studies that have been

conducted were based on “synthetic” data (derived from linking beneficiary survey data to

potential

employer,

Medigap,

or

Medicare+Choice

benefit

designs).

Consumers’

price

responsiveness with respect to the stand-alone prescription drug plans, especially—entirely new

products in the market—may differ substantially from previous estimates.

68

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