Comparison of Observed Harms and Expected Mortality Benefit for Persons in the Veterans Health Affairs Lung Cancer Screening Demonstration Project

Our study used self-reported, cross-sectional data without a comparison group of individuals enrolled in traditional plans.To identify HDHP enrollees, we relied on participants' knowledge of their deductible, because verification of insurance benefits was infeasible.Respondents were sampled from an internet survey panel and may have had different consumer characteristics than nonrespondents.There are a number of ways in which consumer behaviors could be encouraged among and made more helpful to individuals enrolled in HDHPs.Providers could help patients anticipate services that they may need in the future so that patients can try to save for them.Health systems could make prices for services available at the point of care to facilitate patient and clinician conversations about cost.Employers and insurers could go beyond disseminating price information to help patients learn how to use this information in health care decisions.Such efforts will become increasingly important as enrollment in HDHPs continues to increase and could become essential if modifications to the structure or implementation of the Affordable Care Act accelerate patients' exposure to high cost sharing.