More Employees Satisfied with Consumer-Driven Health Plans

The satisfaction gap narrows between traditional health plans and account-based CDHPs

By Stephen Miller, CEBS July 24, 2015

The satisfaction gap is narrowing between employees with traditional health insurance plans and those with consumer-driven health plans (CDHPs), consisting of high-deductible coverage plus a health savings account (HSA) or health reimbursement arrangement (HRA), according to new research from the nonprofit Employee Benefit Research Institute (EBRI).

CDHPs are intended to encourage employees to make more cost-conscious decisions when selecting health care providers for nonemergency care, since unspent funds in an HSA or HRA can be used in lieu of out-of-pocket spending for future health care needs.

Based on findings published in July 2015 from the latest EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey:

61 percent of traditional-plan enrollees said they were extremely or very satisfied with their overall health plans in 2014 (down from 67 percent in 2006).

46 percent of CDHP enrollees were extremely or very satisfied with their plans (up from 39 percent in 2006).

Overall satisfaction rates have been trending upward for CDHP enrollees and downward for traditional enrollees, noted Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report.

The group with traditional health coverage included employees in a broad range of plan types, including health maintenance organizations (HMOs), preferred provider organizations (PPOs) and other managed-care plans. The shared characteristic of these group members was that they either had no deductible or a deductible that was below the minimum-deductible threshold for HSA-eligible plans.

In other survey findings:

Quality of care. CDHP enrollees were as satisfied as individuals in a traditional plan with the quality of care they received. In 2014, about two-thirds of individuals either in a CDHP (66 percent) or in a traditional plan (68 percent) were extremely or very satisfied with the quality of care received.

Access to doctors. Satisfaction levels with getting doctor appointments were high relative to other aspects of health care, regardless of plan type. In 2014, about two-thirds of all plan participants were extremely or very satisfied with their ability to get doctor appointments. Satisfaction rates have been largely flat among traditional-plan enrollees, while they have been trending upward among CDHP enrollees.

HSAs on the Rise

Rising satisfaction with CDHPs is important because the shift to account-based high-deductible plans has been escalating among employers as a way to rein in premium growth by curtailing employees’ health care spending.

The Society for Human Resource Management’s (SHRM’s) 2015 Employee Benefits research report, released in June 2015, showed that among SHRM members:

43 percent of organizations offered HSAs (up from 35 percent in 2011).

30 percent of organizations offered employer contributions to HSAs (up from 20 percent in 2011).

19 percent of organizations offered HRAs (down from 21 percent in 2011).

Unlike HSAs, which can be funded by both employers and employees, HRAs are only employer-funded.

In addition, a survey by consultancy Towers Watson earlier this year showed that while 17 percent of U.S. employers offered one or more CDHPs to employees with no option of selecting a traditional health plan, that figure may increase to nearly 50 percent by 2018 as employers continue to adjust benefit designs to slow the growth of their health care costs.

Nearly half of employers (48 percent) also said they will place more emphasis on educating employees about how to select health care providers (doctors, clinics and hospitals) based on quality and cost information over the next two years.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow Me on Twitter.

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