Table 3:
Relationship between HDHP Offer and Total Family Health Care Spending, by Which Member has a SUD
| (1) | (2) | (3) | (4) | |
|---|---|---|---|---|
| Total family health care spending | Health care spending for member with SUD | Health care spending for other members | Family spending on SUD services | |
|
| ||||
| Average percentage point change in probability of any spending (95% CI) attributable to HDHP offer | ||||
| Post X Treatment | −0.018* (−0.037, 0.002) | −0.016 (−0.036, 0.004) | −0.016* (−0.034, 0.002) | −0.025*** (−0.040, −0.010) |
| Post X Treatment X Member with SUD (ref. = policyholder) | ||||
| Spouse | 0.005** (0.001, 0.009) | 0.006 (−0.005, 0.018) | 0.001 (−0.009, 0.012) | 0.004 (−0.007, 0.016) |
| Adult dependent | 0.006** (0.001, 0.011) | −0.004 (−0.013, 0.005) | −0.000 (−0.009, 0.009) | −0.004 (−0.017, 0.010) |
| Child dependent | 0.009* (−0.000, 0.019) | 0.015* (−0.002, 0.031) | 0.002 (−0.011, 0.015) | 0.002 (−0.020, 0.023) |
| Observations | 317,353 | 317,353 | 317,353 | 317,353 |
| R-squared | 0.246 | 0.120 | 0.237 | 0.155 |
| Pre-HDHP offer mean | 0.990 | 0.949 | 0.902 | 0.392 |
|
| ||||
| Average change in conditional spending (95% CI) attributable to HDHP offer | ||||
| Post X Treatment | −1,648.95*** (−2,862.00, −435.90) | −948.63 (−2,464.79, 567.54) | 592.16*** (−1,015.07, −169.25) | −110.20 (−457.84, 237.44) |
| Post X Treatment X Member with SUD (ref. = policyholder) | ||||
| Spouse | −508.12 (−2,046, 1,029.87) | −811.57 (−3,030.66, 1,407.52) | 518.46* (−79.08, 1,116.01) | −50.51 (−395.45, 294.43) |
| Adult dependent | 579.81 (−588.31, 1,747.94) | −388.99 (−2,216.08, 1,438.10) | 222.28 (−241.92, 686.48) | 668.20*** (211.61, 1,124.79) |
| Child dependent | 1,265.73 (−557.41, 3,088.87) | 2,001.70 (1,022.68, 5,026.08) | −121.72 (−847.47, 604.02) | 44.25 (−457.94, 546.44) |
| Observations | 313,859 | 298,740 | 287,879 | 108,431 |
| R-squared | 0.371 | 0.267 | 0.287 | 0.178 |
| Pre-HDHP offer mean | 20226 | 13826 | 7655 | 3724 |
Notes: The relationship between the family HDHP offer and the probability of any spending and spending, conditional on any spending are shown. Post X Treatment coefficients were calculated a difference-in-differences framework comparing families at treatment (HDHP offer) vs. comparison employers (no HDHP offer) with employer and year fixed effects. Post X Treatment X Member with SUD coefficients were estimated by interactions Post X Treatment with which member of the family had a SUD, with the policyholder as the reference group. All models were adjusted for the documented age, sex, and race/ethnicity of the policyholder, family income and median Census block education levels, the number of family members, and the presence of chronic conditions among any family member derived from the Chronic Conditions Warehouse (CCW) methodology. Probability of any spending were modeled as linear probability models. Spending, conditional on any spending, was log-transformed and coefficient estimates were exponentiated to obtain relative spending coefficients. Pre-HDHP offer means were calculated among families at treatment employers prior to the HDHP offer. All measures were constructed from the OptumLabs Data Warehouse for the years 2007 to 2017.