Though consumer-driven health care plans (CDHPs) are becoming more widespread, many employers are taking a wait-and-see approach toward implementation. In a survey conducted in late 2005 by the International Society of Certified Employee Benefit Specialists and Aon Consulting, about one-third of employers that had not yet implemented a CDHP said they thought the consumer-driven concept was too new and wanted to wait and see other employers' results before going forward.
Companies taking this approach might be interested in the results of a study by McKinsey & Company, a management consulting firm, of consumer-driven health plan participants. Though other studies of CDHP experience have been done, this one was unique in that it examined plans in which the CDHP was the only health benefit offering. The employer plans in the survey were "full-replacement" plans, i.e., when implemented, they replaced previous health plan offerings, rather than being one option from among many. By focusing on full-replacement plans, the study sought to eliminate any adverse selection bias.
According to the results, CDHPs are "delivering on their promise to increase consumer engagement and reduce utilization." The responses of the CDHP participants indicated that they made more careful, value-conscious health care utilization decisions, and that they had a heightened level of engagement in their overall health and wellness.
Five key findings emerged from the study, according to the published report:
• CDHP participants appear to be more value-conscious. For example, although they were twice as likely to report not seeking care for conditions they perceived as less serious, they were no more likely than traditional plan participants to put off treatment for what they thought were serious conditions. Those who had sought treatment (non-pharmaceutical) in the past year were three times more likely to have selected a less intensive (and less expensive) setting, such as an urgent care center rather than an emergency room.
• CDHP participants were as likely or more likely to receive preventive care, and were 20% more willing to take part in company-sponsored wellness programs. They also were more likely than participants in a traditional health plan to say they pursued preventive treatment-such as an annual physical-because it was important for their long-term health or because it would save them money in the long run; traditional plan participants more frequently said they had annual physicals because these services were covered by their health plan.
• Companies in the study reported lower health care costs, even when including costs that had been shifted to employees. Part of the reason for this may be that individuals with chronic conditions who were in a CDHP were 20% more likely than those with traditional insurance to say that they carefully followed their treatment regimens. Also, CDHP participants were nearly twice as likely to discuss less expensive treatment alternatives with their doctor or pharmacist.
• Less than half of CDHP participants said they were as satisfied with their current plan as they had been with their previous plan, a result that did not vary by health status but which did vary widely among companies, suggesting that how a company helps employees transition from traditional to consumer-driven care-and its attendant decision-making responsibilities-is critical to success.
• CDHP participants seem to be more open to their new plans when they perceive factors other than cost-shifting as driving a company's decision to make the switch to a consumer-driven plan.
Research such as this can contribute to the decision-making process as an employer considers adding-or switching to-a CDHP.