In this issue of JAMA, Wharam and colleagues1 report findings from an observational study that assesses the relationship between transition to a high-deductible health plan and use of emergency departments (EDs). The authors use a sophisticated administrative data set, a large sample of patients enrolled in a modern employer-sponsored health plan, and impeccable health services research methods. Their major conclusion is that individuals whose health insurance coverage was switched to a high-deductible health plan, compared with those in a traditional health maintenance organization, reduced overall ED visits by about 10%, mainly for conditions of low and indeterminate severity.
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