EP358: How Health Insurance Plan Design Can Lead to Patients Sacrificing Needed Care, Their Mental Health, and (Sometimes) Buying Groceries, With Wayne Jenkins, MD

How Health Plan Design Drives Patients to Skip Care and Groceries, With Wayne Jenkins, MD. The Financial Toxicity Hiding Inside High-Deductible Health Plans. Episode 358.

Stacey Richter talks with Wayne Jenkins, MD, chief medical officer at Centivo, about a report showing how high-deductible health plan design pushes employees to forgo groceries, skip needed care, and take on mental health strain—and why the conventional wisdom that members will never trade cost-sharing features for savings turns out to be false.

WHAT YOU'LL LEARN

✅ Why high deductibles and excessive cost-sharing are an underlying cause of mounting healthcare affordability problems for workers

✅ Findings on the share of employees who report forgoing groceries in order to afford medical expenses under their health plan

✅ Why medical expenses are a significant driver of mental health and well-being problems for employees and their families

✅ Why the assumption that members will never trade certain plan features for lower costs doesn't hold up in Centivo's research

✅ Why financial toxicity has real downstream health consequences, not just financial ones

✅ Why "narrow and excellent" provider networks aren't necessarily a bad choice for members, contrary to conventional wisdom

WHY THIS MATTERS

The financial risk patients take on just by seeking care in the US is not some hidden secret—most Americans already feel it, and it shows up in skipped groceries, deferred care, and mental health strain. Jenkins's research suggests employers have more room than they think to redesign benefits around actual member behavior rather than assumptions left over from the 1990s.

MENTIONED IN THIS EPISODE

EP308 with Mark Fendrick, MD: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction.

05:23 How is financial toxicity in healthcare affecting patients?

07:02 How do we define a "normal" deductible in today's healthcare?

08:14 What's the point of having a deductible? What does a plan gain from a high deductible?

10:43 How does the cost of a patient's deductible correlate with their use of their health insurance?

15:18 How is health insurance actually sometimes reducing patients' health?

16:24 What is the defining characteristic of those who are more adversely affected by high deductibles?

17:04 Why should CFOs consider plans with lower deductibles for their employees?

18:26 "Are there other ways to approach this in a marketplace, to get more value for what you're paying for so this problem can be addressed?"

21:56 How should employers contemplate health plans moving forward?

22:24 "Having the health plan choice gives more financial viability in addition to that open access."

22:58 "In some sense, [that] can be a zero-sum game. Do you get it in the premium, or is it paid in the higher deductible?"

23:45 "I think there are value choices in the market that may help negate some of the problems that we were just discussing."

25:33 "I think conventional wisdom may be left over from the '90s."

26:49 Why does building these narrow networks have to be a science?

28:38 Does a narrow network adversely affect mental health?

32:20 "Narrow and excellent is not a bad choice for people."