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There’s no question that the cost-sharing burden imposed by health insurance, primarily in the form of hefty deductibles, is higher than ever and continues to rise. For employer-based health plans, the average deductible has more than doubled in the last 10 years, and in 2020, the average family enrolled in a high-deductible health plan faced a whopping $4,552 deductible. Not only does this present a financial burden that many families are simply unable to shoulder, but there is also increasing evidence that high levels of cost-sharing result in worse health outcomes. The good news: There are new ways to help employers and their employees work around high-deductible hurdles.

High-deductible health plan designs (HDHPs), often paired with heath savings accounts (HSAs), gained popularity in the early 2000s in the form of consumer-driven health plan (CDHP) designs that were intended to reduce health care spending by putting consumers more directly in charge of their health care purchasing decisions. By exposing the actual cost of health care services to the individual, HDHPs created a powerful incentive to avoid unnecessary procedures, and to compare prices more carefully, thus reducing overall spending and utilization. Unfortunately, the incentive was perhaps a little too powerful, and as an unintended consequence, many consumers decided to forego or defer care they critically needed, such as prescription drugs, primary, and preventative care. As a result, individuals enrolled in HDHPs often ended up in emergency rooms, and with uncontrolled chronic conditions such as diabetes or high blood pressure.

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