News

Busch Study Reveals Companies Can Control Costs and Improve Employee Use of Preventive Care

Differential cost-sharing approaches in employee health benefits encourage use of preventive care services while controlling a firm’s overall health-care costs according to a new study published in Health Affairs by Yale School of Public Health researchers.

The study, entitled “Effects of a Cost-sharing Exemption on Use of Prevention Services at One Large Employer,” evaluated how Alcoa, the world’s leader in aluminum smelting capacity and the world’s second largest producer of aluminum, implemented a new benefit plan for some employees and their families in 2004. As a way to keep employees healthy and to reduce future health-care costs to the company, the plan provided employees incentives to use preventive care services by completely covering the expenses. For these services, employees and their dependents did not have a co-payment, co-insurance, or a deductible. The plan simultaneously increased cost-sharing for most outpatient and hospital services.

“This study suggests that if employers would like to maintain rates of preventive care use in the presence of higher cost sharing, exempting these services from cost sharing may help,” according to lead author Susan H. Busch, Ph.D., Associate Professor of Public Health in the Division of Health Policy and Administration (HPA) at the Yale School of Public Health. Busch explains that the results of the study may encourage other businesses to exempt preventive care services from cost sharing.

The study found that employees covered under the new incentive plan showed similar use of preventive care services compared with co-workers who were not covered under the new plan. Employees continued to utilize a wide range of covered preventive care services (including cervical and colorectal cancer screenings, well-child visits, and adolescent well care) at the same rate as before the new plan took effect. “Differential cost sharing can help to maintain the use of important health care services,” states Busch. “This has important implications for the use of other high-value services.”

Due to the success of the incentive plan, Alcoa now offers 100 percent preventive care coverage to employees and encourages employees to take advantage of these benefits.

Other authors on this study included Colleen L. Barry, Ph.D., Assistant Professor of Public Health in HPA, Sally J. Vegso, biostatician at Yale Internal Medicine, Jody L. Sindelar, Ph.D., Professor and Head of the Division of HPA, and Mark R. Cullen, M.D., Professor of Internal Medicine at Yale.