Consumer-Driven Plans Creep Forward

 

Thursday, Mar 05,2009, 12:40:19 PM   Click:

Consumer-driven plans before creep

Leah Carlson Shepherd



Employer interest focused on consumer health plans is not in decline, but a lot of employee training is required before the plans can accelerate the sluggish rate of acceptance by employees, according to speakers at the National Consumer -Driven Health Care Summit in Washington, DC, last October.

Over the past four years, there has been a slow increase in the number of employers offering consumer driven health plans and the number of Americans enrolled in consumer-driven health.

"The growth in consumer-based health plans is increasing," said Maureen Sullivan, Senior Vice President of Strategic Services of the Blue Cross Blue Shield Association.

But sometimes there is more talk than action. Sander Domaszewicz, senior adviser at Mercer, said many employers for a replacement plan HSA and then decide against it.

To grow, the number of people enrolled in CDHPs, and the CDHP enrollment who open a savings account, health, health plans and employers must continue to work together to share information with patients on how they can best use their health benefits, Sullivan noted.

"If there is still much education to be done to make consumers aware of how best to use these products, the growth in enrollment and the results on the behavior of CDHP consumers tells us that CDHPs contribute to create incentives for consumer engagement, "she added.

Domaszewicz predicts there will be a continuing trend to be integrated into CDHPs employers efforts in disease management, transparency of price and quality transparency. In this way, consumption in May to move forward based on the value of the scheme.

He urged employers to include adequate funding and training of many employees when they offer CDHPs. Otherwise, employees will spend the necessary care and not understanding how to make good decisions about health care.

When employers use the "cost-oriented way," not to make sufficient contributions to premiums and HSA accounts, employees are satisfied with their benefits. Approximately 28% of employers offer an HSA are not contributions to the accounts of their workers, according to the Kaiser Family Foundation.

Companies that provide some sort of incentive or contribution are the hope of encouraging their employees to choose the CDHP and adopt healthy lifestyles. "The incentives may lead [the health] behavior," said Sullivan of the public. "Those who opened the account behave differently [than those who are not]. The level of commitment is related to the opening of this account. We have seen encouraging results in the measurement of behavior change among those who hold a HSA account.

From 2005 to 2007, nearly half of HSA-eligible plan enrolled said they had not opened an HSA, and 20% to 24% did not open an HSA, citing their inability to afford make HSA contributions or belief, they do not need an account, according to a recent report by the Government Accountability Office.

In general, when employees may choose among several plans, those who enroll in a CDHP tend to be healthier than those who choose a traditional HMO or PPO, Sullivan acknowledged. However, when employers get high participation rates in their CDHP, there is less difference in health risks between the CDHP registered users and traditional plan, Domaszewicz explained.

Case Study

Humana, a Louisville, Ky. to the health insurer, rolled to an HSA to its employees with some success. His data showed that the claims of workers who enrolled in a CDHP had lower use of specialty physicians and diagnosis, and they began to adopt healthy behaviors.

"We found that many of our employees who have been wise began to walk up and teams as a result of the incentive," said Lois Gargotto, Vice President of segment operations for Humana. The company contributes to employee HSA accounts on a sliding scale based on income, but only if the employee pays contributions, as well.

To promote consumption, Humana requires workers to perform an assessment of health risks before they can enroll in health.

Calling for Health Care Reform

Speakers at the conference proposed ideas for reforming health care.

The U.S. health care system needs more competition between providers and insurers, said Regina Herzlinger, a professor at Harvard Business School and author of "Consumer-Driven Health Care: Implications for providers, payers and policymakers." The system is too fragmented and providers focused on the moment, with too few incentives for providers to make care cheaper and better.

She reminded the audience that the country could achieve universal coverage without a single payer, government run system. "The American public will not accept the kind of rationing care for the sick, less consumer-driven health care is not," she added. "Health care is killing the U.S. economy. [The cost of health care] is a huge problem for the overall competitiveness of the U.S. economy."

She also deplored the effects of "job lock," which occurs when employees to stay at work a large company with better health benefits, instead of working in a small firm or start their own business.

Domaszewicz used a personal anecdote to illustrate the need for greater transparency of price and quality transparency.

After some routine work of blood, he tried unsuccessfully for hours to compare prices at different medical laboratories nearby. Many phone calls to the laboratory and its insurer were not responses to prices.

"If it was my shopping experience, I never want to go shopping again. It is terrible, "he said. To be sure, the average patient, without the expertise possessed Domaszewicz on health issues, has a steep hill to climb to discover what the doctor, hospital or treatment is a better value.

Meanwhile, industry observers are closely following the adoption of information technology in health, including medical records and electronic prescribing. In the future, "the big change will be in health care services customized, personalized technology," says Herzlinger.