EBRI Report on Consumer Engagement

The Employee Benefits Research Institute released findings from its most recent survey on Consumer Engagement in Health Care.  The survey covered 1601 adults with traditional insurance coverage, 1941 in high deductible plans and 993 in a consumer-driven health plan, which was defined as a high-deductible plan with an HRA or HSA account associated with it.  Separately, the researchers determined that about 5% of the population was in a CDHP, up from 4% in 2009 and 14% in a HDHP, up from 13% in 2009.  About 12 percent of the commercial population is in a CDHP-eligible plan, although not all those people have actually opened an account.  In general, persons covered by a CDHP or HDHP have been in that plan a shorter time than those in a traditional plan, which makes sense given the growth in enrollment in those plans.   (EBRI Brief)

CDHP enrollees on average do not have higher incomes than those in traditional plans and have similar demographics, but do tend to be more highly educated.  In the past surveys, CDHP enrollees were higher-income than non-enrollees.  From a health standpoint, CDHP enrollees smoked less than those in traditional plans and were less likely to be obese.  The CDHP-covered persons were also more likely to engage in cost conscious behaviors, such as asking for generic drugs, talking to physicians about treatment options and cost and using online cost-tracking tools.   These people were also more likely to take advantage of health risk assessment and health promotion programs.

Financial incentives were no more or less motivating for CDHP members than traditional ones in regard to participating in wellness activities.  These members were more likely to choose a doctor based on his or her use of health IT.  CDHP members were as satisfied as traditional plan ones with the quality of care they received, whereas HDHP members were less satisfied.  Overall satisfaction with health plan was lower for both HDHP and CDHP members than for traditional ones, largely due to cost-sharing, it appears.  People with chronic conditions were just as likely to follow their treatment regimens without regard to plan type.  Overall, it appears that the population in CDHPs is adjusting well to them, although not thrilled about being in one.