TY - JOUR AU - Wharam, J. Frank AU - Soumerai, Steve AU - Trinacty, Connie AU - Eggleston, Emma AU - Zhang, Fang AU - LeCates, Robert PY - 2013 TI - Impact of Emerging Health Insurance Arrangements on Diabetes Outcomes and Disparities: Rationale and Study Design T2 - Preventing Chronic Disease JO - Prev Chronic Dis SP - E11 VL - 10 CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. N2 - Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre-post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes quality of care, outcomes, and disparities. We will use a 13-year rolling sample (2001-2013) of members of an HDHP and members of a control group. To reduce selection bias, we will limit participants to those whose employers mandate a single health insurance type. The study will measure rates of monthly hemoglobin A1c, lipid, and albuminuria testing; availability of blood glucose test strips; and rates of retinal examinations, high-severity emergency department visits, and preventable hospitalizations. Results could be used to design health plan features that promote high-quality care and better outcomes among people who have diabetes. SN - 1545-1151 UR - http://dx.doi.org/10.5888/pcd10.120147 DO - 10.5888/pcd10.120147 ER -