The Employee Benefits Research Institute does an annual survey regarding consumer engagement in their health care. The current iteration was conducted in late 2016 and included about 3300 adults between 18 and 64 with private health insurance, over 80% of whom had employment-based coverage. (EBRI Report) About 165 million Americans have employment-based coverage. 61% of companies with over 500 employees over these people a high deductible plan linked to a savings account, while 24% of employers with between 10 and 499 workers do so. 14% of people were enrolled in a high deductible plan and another 14% in an HDP linked to a health savings account. Of the approximately 22 million people who had access to a plan with a health savings account, 56% opened an HSA, 19% opened an HRA and 25% did nothing. 78% reported that their employer contributed to the savings account, compared to 67% in 2014.
Compared to people not in a high-deductible plan linked to a savings account, those enrolled in such plans demonstrated more engaged behaviors in several ways. They were more likely to check whether a plan covered care, 54% to 44%; to ask for a generic drug, 48% to 37%; and to use an online cost-tracking tool, 31% to 20%. They also were more likely to participate in biometric screening programs, at 80% versus 64% and to talk to their physician about treatment costs and develop a budget to manage health expenses. Employers who offer a high-deductible plan were more likely to also offer wellness programs and CDHP enrollees were more likely to participate. Health plan and provider portals are becoming more common and the savings account members were more likely to use them. CDHPs appear to be continuing steady growth and to lead to more engagement in health or perhaps it is just that more engaged consumers are more likely to enroll.