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What do we really know about consumer-driven health plans?

Paul Fronstin¹

¹Employee Benefit Research Institute, USA.

EBRI Issue Brief

|October 9, 2010

Summary

This summary is machine-generated.

Consumer-driven health plans (CDHPs), including health reimbursement arrangements (HRAs) and health savings accounts (HSAs), offer lower premiums but impact medication adherence. Further research is needed on HSAs and account impacts.

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Area of Science:

Health Economics
Health Services Research
Public Health Policy

Background:

Consumer-driven health plans (CDHPs), encompassing HRAs and HSAs, emerged in response to evolving healthcare landscapes.
Employer adoption of CDHPs increased significantly from 2005 to 2009, with growth observed across various firm sizes.
While initially offering cost savings, CDHPs present complex dynamics regarding enrollee health status over time.

Purpose of the Study:

To synthesize current knowledge on CDHPs, including their offer rates, enrollment, and impact on healthcare utilization and spending.
To evaluate the effects of CDHPs on preventive service utilization and medication adherence among enrollees.
To identify gaps in existing research and highlight areas for future investigation concerning CDHPs, particularly HSA-eligible plans.

Main Methods:

Review and synthesis of existing survey data and research studies on CDHPs.
Analysis of enrollment trends, premium variations, and cost-saving claims associated with CDHPs.
Examination of studies assessing the impact of CDHPs on preventive care and medication adherence.

Main Results:

CDHPs generally exhibit lower premiums than traditional plans, though savings may be partially attributed to healthier enrollees.
Preventive service utilization remains largely unchanged among CDHP enrollees.
Medication adherence shows mixed results, with decreased brand-name drug use and some enrollees discontinuing prescriptions, alongside increased mail-order pharmacy utilization.

Conclusions:

CDHPs present a nuanced approach to healthcare financing, with implications for cost, utilization, and patient behavior.
The long-term health burden of CDHP enrollees may differ from initial expectations, necessitating ongoing monitoring.
Significant research gaps remain, particularly concerning HSA-eligible plans and the influence of account-specific features on healthcare spending and service use.