EBRI: Consumer-driven health plans impact attention to costs, behavior

People who have consumer-driven health plans (CDHPs) appear to pay more attention to their health costs and behavior. That’s according to new research that the Washington, D.C.–based Employee Benefit Research Institute (EBRI) released last month. EBRI works to contribute to, encourage, and enhance the development of sound employee-benefit programs and sound public policy through objective […]

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People who have consumer-driven health plans (CDHPs) appear to pay more attention to their health costs and behavior.

That’s according to new research that the Washington, D.C.–based Employee Benefit Research Institute (EBRI) released last month. EBRI works to contribute to, encourage, and enhance the development of sound employee-benefit programs and sound public policy through objective research and education, according to its website.

Adults who have a consumer-driven health plan and a high-deductible health plan (HDHP) were more likely than those in a traditional plan to “exhibit a number of cost-conscious behaviors.”

The finding is part of the 2015 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS).

The CEHCS examined differences and similarities among individuals enrolled in traditional health plans, CDHPs, and HDHPs. 

The report also looked at consumer engagement more generally and health-care decision-making, cost and quality information, participation in wellness programs, opinions about provider engagement, cost-sharing incentives related to plan type, and telemedicine. Findings from this survey are compared [with] previous EBRI surveys on the subject.

Other findings
The study also found evidence that adults in a CDHP were more likely than those in a traditional plan to be “engaged” in their choice of health plan, according to EBRI.

It found that CDHP enrollees were more likely than traditional-plan enrollees to “take advantage” of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings.

“Employers have been interested in bringing aspects of consumer engagement into health plans for many years, not just through greater cost-sharing but also through wellness programs,” Paul Fronstin, director of EBRI’s health research and education program and the report’s author, said in a news release. “Consumer-driven health plans appear to be having that effect.”

Specifically, the EBRI survey found that those in a CDHP or HDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care. 

They also asked for a generic drug instead of a brand name, talked to their doctors about prescription options and costs, asked a doctor to recommend a less costly drug, talked to their doctors about other treatment options and costs, developed a budget to manage health-care expenses, and used an online cost-tracking tool that the health plan provided, according to the EBRI report.

In addition, those in a CDHP were more likely than those with traditional coverage to say that they had talked to friends, family, or colleagues about the plans; attended a meeting that included explanations on health-plan choices; and consulted with their employer’s human-resources staff about health-plan choices. 

Those in an HDHP were more likely than those with traditional coverage to say that they had visited the health plan’s website to learn about their plan; talked to friends, family, or colleagues about the plan; used other websites to learn about their choices; and that they consulted with an insurance broker to understand the plan, EBRI said.

About the plans
Consumer-driven health plans are a combination of health coverage with high deductibles (at least $1,300 for individual coverage in 2015) and tax-preferred savings or spending accounts that workers and their families can use to pay their out-of-pocket, health-care expenses. 

A handful of employers first started offering CDHPs in 2001 with health-reimbursement accounts (HRAs) and in 2004 employers were able to start offering health plans with health-savings accounts (HSAs).

The 2015 survey found 13 percent of the population was enrolled in a CDHP, 11 percent enrolled in an HDHP, and 76 percent enrolled in traditional coverage. 

The 13 percent of the population with a CDHP represented about 26 million individuals with private insurance, while the 11 percent with an HDHP represented about 22 million individuals. 

Methodology
Researchers conducted the 2015 CEHCS within the U.S. between Aug. 4 and Aug. 21, 2015, through a 12-minute Internet survey. 

The national or base sample was drawn from Ipsos’ online panel of Internet users who have agreed to participate in research surveys. 

More than 2,000 adults ages 21 to 64, who had health insurance through an employer, purchased directly from an insurer, or purchased through a government exchange, were drawn randomly from the Ipsos sample for this base sample. 

Researchers stratified the sample by gender, age, region, income, and race. The response rate was 34.4 percent. 

As a non-probability sample, traditional survey margin-of-error estimates do not apply, EBRI said. However, had the survey used a probability sample, the margin of error for the national sample would have been plus or minus 2.2 percent.

Eric Reinhardt

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