The increased use of consumer-driven health plans with high deductibles are having the desired impact: when people consume more of the costs of their own health care, their decisions are increasingly being driven on how they can personally control the cost, according to the 2016 Consumer Engagement in Health Care Survey by EBRI and Greenwald & Associates.
The inclusion of a high deductible — whether via a high-deductible health plan or a consumer-driven health plan that is associated with a health savings account or a health reimbursement arrangement — is correlated with "more engaged individuals," according to a survey of 3,295 U.S. adults.
"Further, given that CDHP enrollees are more consistently offered funds for their HSA, had a choice of health plans at enrollment and offered wellness programs, CDHP enrollees are more likely to consistently engage in those cost-conscious consumer behaviors," the authors write.
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More than half (56 percent) of CDHP enrollees opened an HSA, taking advantage of growing employer contributions, according to the survey. A majority (78 percent) of CDHP enrollees reported that their employer contributed to the account in 2016, up from 67 percent in 2014. Furthermore, 20 percent of CDHP enrollees reported an employer contribution of at least $2,000 in 2016, up from 10 percent in 2014. Similarly, 42 percent reported an employer contribution of $1,000$1,999 in 2016, up from 36 percent in 2014.
An increase in CDHP enrollment has also led to an increase in "consumer behaviors," the authors write.
Those in a CDHP are more likely to check whether the plan would cover care (54 percent CDHP vs. 44 percent traditional plan); ask for a generic drug instead of a brand name (48 percent CDHP vs. 37 percent traditional); and used an online cost-tracking tool provided by the health plan (31 percent CDHP vs. 20 percent traditional). CDHP and HDHP enrollees are also more likely than traditional-plan enrollees to report that they tried to find cost information before getting care.
CDHP enrollees are more likely to participate in biometric screening programs when offered: Over 80 percent of CDHP enrollees participate, compared with 64 percent among traditional-plan enrollees.
CDHP and HDHP enrollees are also more likely to report that their employer offered a cash incentive or reward for participating in a biometric screening program. Seventy percent of CDHP and 67 percent of HDHP enrollees reported a cash incentive or reward for a biometric screening, compared with 51 percent among traditional-plan enrollees.
Among the top reasons enrollees reported participating in an employer's wellness program were because they were offered incentive prizes, to reduce premiums, and to maintain and improve health.
The survey found that high deductibles were "influencing new behaviors often encouraged by employers and insurers," the authors write.
But while employees are picking up more of the tab, employers are also contributing more to HSAs to help with the costs, according to the survey.
"Employers may have determined that they needed to contribute to the account and that they needed to contribute more than they had in the past in order for CDHPs to be a viable choice for workers when they were offered a choice of health plan," the authors write.
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
