According to research from the Blue Cross Blue Shield Association (BCBSA) individuals enrolled in high-deductible health plans (HDHPs) with a health savings account (HSA) component are more actively involved with their health care and more satisfied with various aspects of their coverage than individuals in traditional plans. The data was collected in an online survey of enrollees in consumer-directed and traditional health plans.

The consumer directed health plan (CDHP) enrollees represented all age groups and their overall self-reported health status did not differ from that of enrollees in traditional plans. However, members of the CDHP group were more likely to seek out information and use health-support services:

• 33% of CDHP enrollees sought information on prescription drug costs (compared with 18% of enrollees in traditional plans);

• 27% used wellness programs (9%);

• 20% sought information on the cost of doctor's office visits (14%);

• 18% used a nurse hot line (8%); and

• 15% used online cost-tracking tools (3%).

Overall, the two groups displayed similar utilization of many health care services. For example, 41% of CDHP enrollees asked for a generic brand when needing a prescription, compared with 40% of enrollees in a non-CDHP plan; 22% of the CDHP group delayed seeing a doctor or having a medical procedure (25% non-CDHP); and 18% of enrollees in both groups delayed filling or decided not to fill a prescription that had been written for them.

The CDHP enrollees also expressed greater satisfaction levels with various aspects of their plan:

• 68% of HSA-eligible enrollees were satisfied with the overall performance of their insurer (compared with 56% of non-CDHP enrollees);

• 71% were satisfied with their access to preventive care and wellness services (57%);

• 69% were satisfied with the health benefits information they received from their plan (55%); and

• 67% were satisfied with the responsiveness of their plan's customer service (55%).

Overall, 61% of the CDHP group said they were likely or very likely to recommend their plan to others, compared to 47% of the traditional plan enrollees.

Of the survey respondents who were CDHP enrollees, 12% had been uninsured in the previous year, compared with 6% of traditional plan enrollees.

Data such as this can help to dispel certain misconceptions that CDHP plans attract mainly young and healthy participants and that participants may delay or avoid seeking necessary health care services. These results, along with enrollees' expressed satisfaction levels, may lead more individuals and employers to consider the CDHP as a health plan option.

In addition, data from other sources does indicate that this, indeed, is happening. An ongoing census by America's Health Insurance Plans of its member companies-health insurers-found that the number of people covered by HSAs/HDHPs exceeded 1 million (1,031,000) in March 2005, and had more than doubled over a six month period. Kaiser Family Foundation's 2005 Annual Employer Health Benefits Survey found that 20% of the surveyed employers that offered health insurance provided a HDHP option. Also, a separate survey by Mellon Human Resources and Investor Solutions found that while 7% of its surveyed group (primarily large employers) offered HSAs in 2005, 32% planned to offer this health plan option in 2006.