A literature review of studies relating to consumer behavior with HDHPs found that these plans reduced the use of both appropriate care, such as preventive screenings, and inappropriate care, such as unnecessary emergency department visits (Agarwal et al., 2017). To date, research generally has not focused on health outcomes of HDHP users. Some recent studies have shown consumers rarely engaging in priceconscious behavior, instead achieving savings through use of fewer services (Kullgren et al., 2018; Kullgren et al., 2019;

Sinaiko et al., 2016; Sood et al., 2013).

Do HDHPs achieve the right balance of providing insurance coverage while incentivizing consumers to use resources prudently? Or, are they simply a way to lower employer healthcare costs while making it unaffordable for many consumers to obtain the health care they need? How easy is it for consumers to compare costs for healthcare providers and services? What additional challenges might an HDHP present for individuals who are low income, live in rural areas, speak a primary language other than English, or have low health literacy?