Consumer-directed health plan members are more cost-conscious and engaged in wellness programs than their counterparts in traditional plans, an Employer Benefit Research Institute survey revealed.
Overall, however, satisfaction rates are higher for traditional plan members than CDHP members because CDHPs are still relatively new in the market and more complex, said EBRI spokesman Paul Fronstin.
CDHP satisfaction has been rising, but payers need to focus on retention. While CDHPs enjoy higher levels of consumer engagement initially, overall engagement declined in 2008 and 2009, said Carl Doty, research director for Forrester Research. Consumers revert back to complacency about their health status in the absence of useful payer-provided tools and programs that help them save time and/or money, he said.
Aetna doesn’t track retention, but as of September 2009, the payer had 1.8 million members in a CDHP, according to spokeswoman Kathy Campbell, head of product development. Approximately 84 percent of people enrolled in a qualified high-deductible health plan have an active health savings account.
“We’ve seen continual growth in our CDHP products in every customer size segment,” she said.
Aetna’s 2007 Aetna Health Fund Study, published in March 2009, showed that employers gained savings over a five-year period. The study also found that Aetna HealthFund members spend more on preventive care and had lower PCP use for non-routine services and lower use of specialist care than their PPO counterparts, Prout said.
“HRA and HSA members with chronic conditions maintained or increased the use of drug therapies for their conditions,” she said. “AHF members were twice as likely to use online consumer tools and information than PPO members – a leading indicator of employee engagement.”
“WellPoint’s persistency rates for its CDHP products are meeting persistency goals,” said spokeswoman Cynthia Sanders. She attributes the growth to rates, benefit options and WellPoint’s strong provider networks.
Its CDHP members have higher use rates for preventive care services than members enrolled in non-CDHP products, she said. “As more tools and programs become available to CDHP members, consumer engagement rates will only increase,” she said.
WellPoint’s CDHP product lines continue to grow monthly and are expected to continue through 2010, Sanders said.
Cigna’s Fourth Annual Cigna Choice Fund Experience Study revealed that medical costs for account-based CDHP members declined 26 percent over four years. Levels of care for preventive medicine, chronic disease management and evidence-based treatments are higher for CDHP members than members in traditional managed care plans.
“Adoption rate for Cigna CDHP has grown exponentially year over year since we began offering these plans in 2005, where we’ve gone from zero to more than 10 percent of our book of business being customers covered in CDH plans,” said spokesman Joseph Mondy.
The key components to increased CDHP adoption and retention are online decision-support tools and “benefit-neutral plan” design, which offers benefit levels comparable to the member’s previous traditional plan, he said.
“This approach has been proven to reduce costs year-over-year without shifting costs to individuals,” he said.
“We’ve had a good growth rate and we expect to continue to grow as the data shows that the higher levels of health engagement by individuals in CDH plans cause costs to go down as quality goes up,” Mondy said.