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EBRI: Consumer Directed Health Plan members more likely to research healthcare costs

New research from the Employee Benefit Research Institute (EBRI) shows the employees enrolled in a Consumer Directed Health Plan (CDHP) are more likely than members of traditional health plans to exhibit cost-conscious behaviors including doing additional research on healthcare costs.

The research shows that while traditional health plan members and CDHP members were equally likely to use quality information, CDHP members were both more likely to use the cost information provided by their health plan and to use sources other than their health plan's for cost and quality information. In addition, the EBRI research from its 2012 EBRI/MGA Consumer Engagement in Health Care Survey found CDHP members were more likely to engage with a range of wellness programs and that the financial incentive attached to these programs mattered more to them than members of traditional employer-based health plans.

"It is clear that the underlying characteristics of the populations enrolled in these plans are different," said Paul Fronstin, director of EBRI's Health Research and Education Program and author of the report, in a press release. "Adults in a CDHP were significantly more likely to report being in excellent or very good health, and they were significantly more likely to exercise."

The new research comes as the numbers of people enrolled in both CDHPs and high-deductible health plans (HDHPs) continue to swell. According to EBRI, 18.6 million adults ages 21 to 64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or were in an HDHP that was eligible for a health savings account (HSA). When accounting for the children associated also enrolled in these plans through their parents, the total number of people enrolled in 2012 in either a CDHP or HDHP totaled 25.2 million or 14.6 percent of those enrolled in private insurance. CDHP enrollment alone grew from 7 percent in 2011 to 10 percent in 2012.

Enrollees in these programs as a group were also distinct from traditional plan enrollees in other ways: significantly more reported their health as either excellent or very good; significantly more were likely to exercise; enrollees were significantly less likely to smoke; and CDHP and HDHP enrollees were more highly educated.

While more people are choosing these types of health plans as a means of lowering their overall premium costs, Fronstin noted that the relatively low numbers of enrollees in CDHPs and the relatively short amount of time people have been enrolled in the programs make it too early to tell if they are effective or not at lowering overall healthcare expenditures, regardless of the healthier attributes associated with their members.

"It is not clear from the data whether the differences in consumer engagement can be attributed to plan design differences or whether various plan designs attract certain kinds of individuals," the report stated. "As the CDHP and HDHP markets continue to expand and more enrollees are enrolled for longer periods of time, the sustained impact that these plans are having on cost, quality, and access to health care services can be better understood."