In an effort to rein in health care costs and encourage employees to take greater responsibility for their health, a growing number of employers are offering consumer-driven health plans (CDHPs) linked to a health savings account (HSA) or to a health reimbursement arrangement (HRA), according to new research from Aon Hewitt. CDHPs have become the second most prevalent plan offered, after preferred provider organizations (PPOs), and could potentially surpass PPOs as the most common plan type in the next three to five years.
According to the consultancy's 2013 Health Care Survey of nearly 800 large and midsize U.S. employers:
- Fifty-six percent of organizations offer CDHPs as a plan choice, and another 30 percent are considering offering one in the next three to five years.
- Ten percent of employers offer CDHPs as the only plan option, and another 44 percent may do so in the next three to five years.
- Companies reported at least a 2 percentage point lower cost trend growth for CDHPs (with 4 percent annual cost increases) versus other plans, including PPOs (6 percent), health maintenance organizations (7 percent) and exclusive provider networks (6 percent).
“Employers are increasingly embracing plan designs that are cost-effective, promote consumer choice and accountability, and encourage employees to be more deliberate in how they spend their health care dollars,” said Aon Hewitt Senior Vice President Maureen Fay.
To encourage employees to enroll in CDHPs, organizations are using a variety of tactics, including:
- Subsidizing premiums at a higher level than they do for other plan options (44 percent of respondents).
- Making the high-deductible health plan the default plan option (22 percent).
More employers are also covering preventive medicines before the deductible applies, but this solution is available only to CDHPs linked to an HRA. That's because HSAs are not permitted to cover medications for chronic conditions until the worker meets the health plan's deductible.
Driving Behavior Change
In separate research reported in Aon Hewitt’s 2013 Consumer Health Mindset Survey, a little over three-quarters of consumers enrolled in a CDHP said they were satisfied with their plan choice, and 89 percent said they planned to re-enroll.
Of those employees who had been in a CDHP for more than two years, 97 percent planned to re-enroll, indicating that satisfaction with this plan rose over time.
In addition, the study showed a correlation between participation in a CDHP and making more-informed health decisions:
- Sixty percent of employees who were enrolled in CDHPs said they made positive behavior changes related to their health.
- Twenty-eight percent said they received routine preventive care more often.
- Twenty-three percent sought lower-cost health care options.
- Nineteen percent researched health costs more frequently.
Stephen Miller, CEBS, is an online editor/manager for SHRM.
Consumer Satisfaction Rises for CDHPs, Still Trails Traditional Plans, SHRM Online Benefits, September 2013
Misunderstanding HSAs Poses Open-Enrollment Hurdle, SHRM Online Benefits, August 2013
In Case Study, HSA Shift Led to Sustained Savings, SHRM Online Benefits, August 2013
For 2014, Higher Limits for HSA Contributions, Out-of-Pocket Expenses, SHRM Online Benefits, May 2013
Consumer-Driven Decision: Weighing HSAs vs. HRAs, SHRM Online Benefits, updated May 2013
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