For decades, plan designs and employer-sponsored health plans shielded employees from the true cost of health care.
- $20 office visit copayments hid even discounted fees from patients
- $10 prescription copayments gave a false sense of affordability
Employers could talk about the real cost, but until employees had some skin in the game, the message did not hit home.
Enter Consumer-Driven Health Plans (CDHPs).
These plans attempt an infusion of individual accountability by combining a high-deductible health plan with a tax-favored savings plan.
But, are CDHPs working?
A recent study shows a mixed bag in terms of results.
CDHPs have been around since the early 2000s, typically in one of two forms.
In an effort to stop the hemorrhaging of health care costs, an increasing number of employers are offering CDHPs.
To transition employees into the consumer-driven plan, most employers offered CDHPs alongside traditional health plans. However, the trend is moving towards CDHPs as the only health plan option offered.
A Towers Watson/National Business Group survey of employer sponsors of health benefits projects 14 percent of employers (with over 1,000 employees) will offer CDHPs as the only option in 2013 (up from 8 percent in 2012).
The June 2013 issue of Health Affairs published a new study’s research findings in Consumer-Directed Health Plans Reduce the Long-Term Use of Outpatient Physician Visits and Prescription Drugs.
One of the problems with assessing CDHPs is the impact of multiple plans on results.
Multiple health plan options affect which employees choose CDHPs. That makes it difficult to determine if a result is due to the CDHP design or the profile of a person who chooses that type of plan over a traditional plan.
The selected employer for the study offered only a CDHP (an HSA) for four years, making the study the longest of its kind.
Researchers compared results with another large employer without a CDHP.
The infograpic below depicts some of the study’s findings.
While the numbers appear low for physician visits and prescriptions, the researchers advise they are considered statistically significant.
The researchers did not expect the increased emergency room (ER) visits, particularly since they did not associate the ER visits with higher inpatient use.
Cancer screenings rebounded somewhat from the first year drop in the CDHP, but still ran lower than baseline recommendations. After the first year, there was no difference between the CDHP group and the non-CDHP group in cancer screenings.
A decrease in these preventive services is not what CDHP proponents hoped for.
2014 should test CDHPs further when a healthy portion of health reform provisions are enacted.
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.