CDHP, HDHP enrollment rates see slow growth

The number of individuals enrolled in consumer-driven health plans hit 22 million in 2010, reflecting a 1% increase compared to 2009, report researchers from the Employee Benefit Research Institute and Mathew Greenwald and Associates.

Enrollment in high-deductible health plans also increased by 1% in 2010, with 17.2 million people covered under the plans.

The research, which is outlined in an issue brief titled "Findings from the 2010 EBRI/MGA Consumer Engagement in Health Care Survey," shows CDHP enrollment rose by 5% (5.7 million people) for the privately insured population in 2010, up from 4% in 2009. Meanwhile, HDHP enrollment jumped to 14% (17.2 million people) for the same population in 2010, up from 13% in 2009. 

"The number of people who are enrolled in so-called 'consumer-driven' private health care plans is slowly growing.  It takes time for people to catch on to anything new," says Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report.

Adoption rates will outpace enrollment rates. "Among jumbo employers more than 50% offer a CDHP.  Enrollment is slow partly because people have other choices.  Once those choices phase out or when employers provide added incentives to join a CDHP, enrollment will pick up," Fronstin explains.

The analysis looks at the behavior and attitudes of 4,509 adults ages 21 to 64 with private health insurance coverage. Other key findings in the survey include:

  • Enrollees in CDHPs and HDHPs exhibit more cost-conscious behaviors than those in traditional health care plans, such as checking to see whether the plan would cover specific care ( CDHPs 53% , HDHPs 53% and traditional 47%), and asking for a generic drug instead of a brand name (CDHP 51%, HDHP 50% and traditional 44%).
  • Three-quarters of CDHP enrollees participated in a health risk assessment program, compared with 60% of traditional plan enrollees. Similarly, 52% of CDHP enrollees participated in a health promotion program, compared with 41% of traditional plan enrollees.
  • Financial incentives are not a factor, but the use of health information technology is: Financial incentives were no more a factor for CDHP enrollees than for traditional plan enrollees when it came to participating in wellness programs. However, CDHP and HDHP enrollees were more likely than traditional plan enrollees to choose a doctor based on his or her use of health information technology.
  • Generally, about one-half or more of CDHP and HDHP enrollees are likely to choose a doctor based on his or her use of HIT, whereas between 40%−50% of traditional plans' enrollees are likely to do so.
  • Health status is better: In 2010, 9% of adults enrolled in CDHPs, 12% in HDHPs, and 15% of those with traditional coverage smoked cigarettes.
  • People in CDHPs were also more likely to exercise in all years of the survey except 2010, and they were less likely to be obese compared with adults enrolled in a traditional health plan in some years, including 2009 and 2010.

However, researchers note: "It is not clear from the data whether the differences in consumer engagement can be attributed to plan design differences or whether various plan designs attract a certain kind of individual."
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