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Move increases preventive care and generic refills, reduces ER visits
Americans enrolled in consumer-driven health plans (CDHPs) are more likely than others to make sustainable, positive behavior changes leading to significant health plan spending reductions year over year, according to data studied by Health Care Service Corp. (HCSC), operator of the Blue Cross and Blue Shield plans in Illinois, Texas, Oklahoma and New Mexico.
Members who migrated to CDHP plans—which have a high deductible, prompting consumers to be more directly involved with the selection and use of health care services—reduced their health care spending significantly.
The study tracked individual members who migrated from traditional health plan coverage to CDHP coverage in order to analyze their health care behavior and their health care spending habits before and after the switch. The data, released in June 2012, showed that changes in behavior, including increases in preventive care and use of generic prescriptions, helped contribute to a reduction in health care spending for employers and consumers.
The CDHP program in the study, BlueEdge, was offered through the four Blue Cross/Blue Shield plans operated by HCSC and included health savings account (HSA) and health reimbursement arrangement (HRA) options (see the SHRM Online article "Consumer-Driven Decision: Weighing HSAs vs. HRAs"). BlueEdge enrollment surpassed 1.5 million members in the first half of 2012 after experiencing double-digit percentage increases for six straight years.
After the Switch ...
Key results from the study indicate that, following migration from a traditional non-CDHP plan to a CDHP, on average, the CDHP members studied:
• Were 4 percent more likely to take advantage of preventive services.• Reduced health care use by an aggregate of more than 12 percent.• Were 10 percent more likely to fill their prescriptions with generics.• Spent 24 percent less on inpatient hospital services and 8 percent less on outpatient services.• Had a 12 percent decrease in emergency room (ER) visits.• Reduced combined medical and pharmacy spending by an aggregate of 11 percent.
• Were 4 percent more likely to take advantage of preventive services.
• Reduced health care use by an aggregate of more than 12 percent.
• Were 10 percent more likely to fill their prescriptions with generics.
• Spent 24 percent less on inpatient hospital services and 8 percent less on outpatient services.
• Had a 12 percent decrease in emergency room (ER) visits.
• Reduced combined medical and pharmacy spending by an aggregate of 11 percent.
In addition, data showed that employers who offered only a CDHP saw even greater spending reductions—up to an aggregate of 14.4 percent over the three years—following migration from a traditional plan to a CDHP.
“Our experience finds that CDHP members tend to be more engaged and informed in making better health care decisions,” said Thomas Meier, vice president, product development, at HCSC.
The study analyzed more than five years of data for more than 265,000 enrolled members (with pharmacy data available on 121,000 of those members).
Stephen Miller, CEBS, is an online editor/manager for SHRM.
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