Behind the slow enrollment growth of employer-based consumer-directed health plans

Despite the buzz about empowering consumers and controlling rising health costs, consumer-directed health plans (CDHPs)--defined as high-deductible plans coupled with savings accounts--have barely gained a toehold among Americans with employer-sponsored insurance, according to a new national study by the Center for Studying Health System Change (HSC). CDHP proponents often assert the plans offer employees greater choice and autonomy in the health care marketplace, but 39 percent of the estimated 2.7 million workers enrolled in employer-sponsored CDHPs had no choice of another type of health plan in 2006. Moreover, among workers with a choice of plans, relatively few (19%) choose CDHPs when offered another type of plan option, such as preferred provider organizations (PPOs) or health maintenance organizations (HMO). Comparable take-up rates for PPO and HMO plans when employees have a choice of another plan type were 55 percent and 40 percent, respectively.