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Invited Commentary
March 2017

Precision Benefit Design—Using “Smarter” Deductibles to Better Engage Consumers and Mitigate Cost-Related Nonadherence

Author Affiliations
  • 1Center for Value-Based Insurance Design, University of Michigan, Ann Arbor
  • 2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2017;177(3):368-370. doi:10.1001/jamainternmed.2016.8747

Increasing consumer cost-sharing (eg, deductibles, copayments) is a frequently used strategy to minimize the growth of health insurance premiums due to escalating health care expenditures. The 2016 National Health Interview Survey reports that 40.0% of those younger than 65 years with private health insurance are enrolled in a high-deductible health plan (HDHP), a sharp increase from 25.3% in 2010.1 Similarly, a 2016 Kaiser Family Foundation survey shows that the average health plan deductible has increased from $818 in 2006 to $2069 in 2015.2 People enrolled in plans with a deductible are required to pay the full cost of most medical care until the plan deductible is met.