Consumer-Driven Plans Show Increased Employee Involvement

CDHP enrollees were more cost-conscious in their decision-making

By Stephen Miller, CEBS Jan 5, 2015

Employees enrolled in consumer-driven health plans (CDHPs) are more involved in their health care, a report from the nonprofit Employee Benefit Research Institute (EBRI) indicates.

CDHPs include a combination of health coverage with high deductibles (at least $1,250 for individual coverage in 2014) and eligibility for tax-preferred savings or spending accounts that workers and their families can use to pay their out-of-pocket health care expenses. The plans are intended to provide incentives that promote cost- and health-conscious decision-making. A handful of employers first started offering CDHPs in 2001 with health reimbursement arrangements (HRAs), and in 2004 employers were able to start offering plans with health savings accounts (HSAs).

The 2014 Consumer Engagement in Health Care Survey, published in EBRI’s December Issue Brief, showed that about 15 percent of the U.S. population was enrolled in a consumer-driven health plan (CDHP) vs. 74 percent that was enrolled in more-traditional health insurance coverage. About 26 million individuals with private insurance were enrolled in a CDHP in 2014. (Findings released in November 2014 by Mercer showed that among those with employer-provided insurance, 23 percent were enrolled in CDHPs.)

CDHP enrollees were more cost-conscious in their decision-making than those in traditional plans, the EBRI survey revealed. They were more likely than traditional-plan enrollees to:

Use cost information before getting health care services.

Take advantage of wellness programs, such as health risk assessments, health promotion programs and biometric screenings.

“It’s also clear that financial incentives matter more to CDHP enrollees than they do to traditional-plan enrollees,” said Paul Fronstin, director of EBRI’s Health Education and Research Program and co-author of the report.

Cost-Conscious Behaviors

Among individuals enrolled in CDHPs, 57 percent had an HSA or HRA, while 43 percent were enrolled in HSA-eligible health plans but had not opened an account, the survey showed. Adults in a CDHP were more likely than traditional-plan enrollees to exhibit cost-conscious behaviors such as:

Checking whether the plan would cover specific care and the price of a service before getting care (for instance, by using an online cost-tracking tool provided by the health plan).

Talking to their doctor about prescription options and costs, and asking about less costly prescriptions such as a generic drug instead of a brand name.

Developing a budget to manage health care expenses.

Weighing Plan Options

Adults in a CDHP also were more likely than those in a traditional plan to be engaged in their choice of health plan. Specifically, those in a CDHP were more likely to have attended a meeting where health plan choices were explained and to have consulted with their employer’s HR staff about health plan choices.

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

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