One of the techniques used to encourage consumers to pay more attention to their health and health care and to help employers manage their health cost is the use of health insurance designs that feature high deductibles and other cost sharing benefit designs, often coupled with a health savings account. The Employee Benefits Research Institute has undertaken an annual survey of privately insured adults to ascertain the extent of enrollment in these plans, the characteristics of enrollees compared to persons in other plan designs and how the health behavior of these enrollees may differ. This year’s report covers about 4500 respondents. (EBRI Report) In 2012 about 25 million people, privately insured adults and their dependents, were enrolled in a CDHP or an HSA-eligible plan. This is about 14.6% of the total market. Many of the people eligible for an HSA have not activated the feature. Slow but steady growth in CDHP enrollment continues and more employers are offering this design as an option, or in many cases the only option. An growing number of people have been in a CDHP for multiple years, which likely increases their understanding of how the plan works and their ability to take advantage of its features. About 60% of adults in a CDHP say they are extremely or very familiar with how it works.
Individuals in CDHPs are much more cost conscious than enrollees in other plan designs. These persons often check on costs of various treatments, use generic drugs and seek quality information. They also are more likely to fill out health risk assessments and have access to wellness and screening programs. When people don’t participate in wellness activities, the most common reason is a believe that they can do it on their own, followed by lack of time. Incentives for participation offered by employers appear to have a positive effect on participation. Most enrollees in all types of plans seem generally satisfied that their doctors are caring for them as a person and tries to keep them healthy. A surprisingly large number use providers that qualify as medical homes. About 60% of adults with private insurance have a smartphone and 40% a tablet. About a third of these people had used the device for a health related purpose.