[3] As of 2016, HDHPs represented 29% of the total covered workers in the United States; however, the impact of such benefit design is not widely understood.
According to the instructions for IRS form 8889, "this limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers.
[17] Advocates of Consumer-driven healthcare (CDHC) such as HDHPs operate on the premise that imprudent choices made by patients may be avoided if they are held financially responsible through high copayments and deductibles.
[15] An HDHP's total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can't be more than $7,500 for an individual or $15,000 for a family.
[21] As a way to try and offset the cost of care, HDHP policy holders may contribute to a health savings account (HSA) with pre-tax income.
Success of this theory depends on ability of patients to make informed decisions on their health care purchase[30] similar to what they do for goods and services.
When patients postpone necessary or preventative care (outpatient visits, screening and diagnostic testing), they may end up in hospitals' emergency rooms or wards for treatment.
"Introduced in 2003 as a part of the Medicare prescription drug benefit legislation, the HSA is a less-restrictive medical savings account, owned by the employee, and open to anyone enrolled in a [HDHP] and not already covered by public or private insurance" 5 .
[36] From a physician/hospital supply, HDHP have forced institutions to become more consumer conscious as patients (due to price shopping) do their own research and understand their options.
The same goes for specialists as well who see less patients undergoing preventative screening and maintenance care (colonoscopies, mammograms, routine laboratory testing, etc.)
Physicians struggle with having cost become a greater reason for opting for or against a medical interaction or procedure than the health benefits for the individual[citation needed].