However, the effects of CDHPs
on spending in the longer term are a priori ambiguous and the empirical evidence on the long
term effect of CDHPs on spending is limited (Fronstin et al., 2013; Borah et al. 2011; Wharam et
al. 2011). In this paper, we address this gap in the literature by describing a theoretical
framework for long term impacts and empirically evaluating the long term effects of CDHPs on
health care spending