The ranks of people enrolled in either a consumer-driven
health plan (CDHP) or a high-deductible health plan (HDHP) reached 22 million
in 2010, according to a report released by the nonpartisan Employee Benefit
Research Institute (EBRI).
Participation in these account-based health care plans is
low, but continues to grow, EBRI finds in its sixth annual Consumer Engagement
in Health Care Survey (CEHCS).
The EBRI report found that enrollment in CDHPs rose to five
percent of the privately insured population (5.7 million people) in 2010. It
stood at four percent last year. Enrollment in HDHPs increased to 14 percent
of the privately insured population (17.2 million people) in 2010 from 13
percent in 2009.
The data are based on the 2010 CEHCS, which analyzed the behavior and attitudes of 4,509 adults
ages 21-64 with private health insurance coverage.
Selecting alternatives
"The number of people who are enrolled in so-called 'consumer-driven' private health care plans is slowly growing," said Paul
Fronstin, director of EBRI's Health Research and Education Program and author
of the report. "And as employers continue to look for ways to manage health
care cost increases, they are turning to these account-based plans. EBRI will
continue to track their impact on cost, quality, and access to health care."
Employment-based health benefits are the most common form of
health insurance in the United States, but skyrocketing health expenses have
forced employers to seek ways to control their costs.
In recent years, employers have turned their attention to
account-based health plans -- a combination of health plans with deductibles of
at least $1,000 for employee-only coverage and tax-preferred savings or
spending accounts that workers and their families can use to pay their
out-of-pocket health care expenses.
The consumer-driven health plans are designed to give
workers more control over how they pay for their health coverage.
Comparing attitudes
EBRI's survey tracks workers' enrollment in and attitudes
toward their health plans, comparing those in traditional health plans with
those in the newer consumer-driven and high-deductible plans. It finds that
enrollees in CDHPs and HDHPs exhibit more cost-conscious behaviors than those
in traditional health care plans, such as checking to see whether the plan
would cover specific care (CDHPs 53 percent, HDHPs 53 percent, traditional 47
percent), and asking for a generic drug instead of a brand name (CDHP 51
percent, HDHP 50 percent, traditional 44 percent).
The survey also found:
- CDHP enrollees are more engaged in either a health risk assessment or healthpromotion program: Three-quarters of CDHP enrollees participated in a health riskassessment program, compared with 60 percent of traditional plan enrollees. Similarly, 52 percent of CDHP enrollees participated in a health promotion program, compared with 41 percent of traditional plan enrollees.
- Financial incentives are not a factor, but the use of health information technology(HIT) is: Financial incentives were no more a factor for CDHP enrollees than for traditional plan enrollees when it came to participating in wellness programs. However, CDHP and HDHP enrollees were more likely than traditional plan enrollees to choose a doctor based on his or her use of health information technology (HIT). Generally, about one-half or more of CDHP and HDHP enrollees are likely to choose a doctor based on his or her use of HIT, whereas between 40'50 percent of traditional plans enrollees are likely to do so.
- Health status is better: In 2010, nine percent of adults
enrolled in CDHPs, 12 percent in HDHPs, and 15 percent of those with traditional coverage
smoked cigarettes. People inCDHPs were also more likely to exercise in all years of the
survey except 2010, and they were less likely to be obese compared with adults enrolled
in a traditional health plan in some years, including 2009 and 2010.
