Satisfaction Gap Slims Amid Traditional and CDH Plans

Out-of-pocket costs still a major factor

By Stephen Miller, CEBS Aug 18, 2014

Who’s happier with their health plan—those in traditional managed care plans, or those in consumer-driven and high-deductible plans?

The latest data from the nonprofit Employee Benefit Research Institute, published in the August 2014 EBRI Notes, show that the overall satisfaction rate among consumer-driven health plan (CDHP) enrollees is gradually increasing, while it is gradually decreasing among traditional enrollees.

Nevertheless, significantly more people in traditional plans are satisfied with their health coverage than are those in the newer types, and out-of-pocket costs may explain some of the variation in overall satisfaction rates.

CDHPs include health plans with health savings accounts (HSAs) funded by employers and employees, or health reimbursement arrangements (HRAs) funded solely by employers. The intention is to provide employees with a financial incentive to make cost-conscious decisions about their care. HSAs must be linked with high-deductible health plans; HRAs typically are tied to high-deductible plans although this is not a statutory requirement. Moreover, some employers provide high-deductible plans that are not coupled to either an HSA or HRA (see the SHRM Online article Consumer-Driven Decision: Weighing HSAs vs. HRAs).

“As in previous years of the survey, in 2013 individuals in a CDHP or an HDHP [high-deductible health plan] were found to be less likely than those in a traditional plan both to recommend their health plan to friends or co-workers, and to stay with their current health plan if they had the opportunity to switch plans,” wrote Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the study report. “However, the percentage of HDHP and CDHP enrollees reporting that they would be extremely or very likely to recommend their plan to friends or co-workers has been trending upward, while it has been flat among individuals with traditional coverage.”

Quality of Care

Individuals in a CDHP were nearly as satisfied as individuals with traditional coverage with the quality of care received. In 2013, about two-thirds of individuals whether in a CDHP (67 percent) or with traditional coverage (68 percent) were extremely or very satisfied with the quality of their care.

But individuals with a high-deductible health plan without an HSA or HRA were less likely to be satisfied with their care, with 61 percent saying they were extremely or very satisfied with the quality of care received.

Out-of-Pocket Costs

In 2013, 44 percent of traditional-plan participants were extremely or very satisfied with out-of-pocket costs (for health care services other than for prescription drugs), EBRI found, while 20 percent of high-deductible health plan enrollees and 31 percent of CDHP participants were extremely or very satisfied. Satisfaction has been trending upward among CDHP enrollees in recent years but downward among those in traditional plans.

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