As consumer-directed, or high-deductible, health plans have grown in popularity, a number of sources have attempted to ascertain total enrollment in them and the latest is the American Association of PPOs. (AAPPO Survey) This group utilized data from a Mercer survey and Census Bureau information, AAPPO estimated that about 39 million people were in consumer-directed plans in 2012, up from about 33 million in 2011, for a growth rate of 19%. No other type of private insurance plan showed any significant growth. About 36% of large employers–those with more than 500 employees–offered such a plan, up slightly from 2011, and about 22% of small employers did so. Among very large employers with more than 20,000 workers, 59% provided a CDHP. Small employers were the most likely to have a consumer-directed plan be the only offering. Enrollment is highest in the Midwest and lowest in the west. Forty percent of all employers expect to be offering a CDHP within five years and more employers are considering having it as the only insurance option. CDHPs with an HSA are more popular than those with an HRA, but not by a lot. The analysis provides more evidence that these plans, with their increased cost-sharing, are becoming a mainstream health insurance approach and are continuing to increase membership.
