Consumerism Doesn't Simply Mean Shifting Costs to Members

Les Masterson, for HealthLeaders Media , April 29, 2009

The best in class also helped employees and their families make informed decisions to better manage their health, spending, and overall wellness through providing cost of care, benefits information, and the Aetna Navigator member Web site. Those employers also reduced employee premium contributions for those in HealthFund.

As employers search for ways to cut healthcare costs, CDHPs will remain a viable option. But employers and health plans must not look at CDHPs as merely a way to transfer costs onto the individual. That does not work and will only force members to put off vital care, both preventive and chronic.

Instead, health plans and employers should view CDHPs as a way to change the dynamic. This will take time as members have become accustomed to insurers taking on much of the decision-making responsibility.

Consumerism means member empowerment, but health plans and employers need to actually educate the individual. They can't merely create a Web site with a glossary of healthcare terms and set up an HSA. These stakeholders must also invest in member outreach and conduct lengthy education campaigns.

With a public insurance option close to becoming a reality, the future of health plans could be riding on the success of CDHPs.

Health insurers view CDHPs as a cost-saving, patient-empowering movement, as was evident in the health plan portion of the HealthLeaders Media Industry Survey 2009, but the percentage of employees enrolled in a CDHP is still often in the single digits in the small employer market. Large employers that have invested in CDHPs, however, are finding more interest.

In fact, the 14th annual National Business Group on Health/Watson Wyatt Employer Survey on Purchasing Value in Health Care found that 43% of large employers surveyed said they have more than 20% employee enrollment in a CDHP and the median enrollment has increased to 14% in the large employers surveyed.

The percentage of employees in CDHPs is important because getting more employees enrolled in those plans correlates with lower costs. In looking at cost trends and basic costs, Ted Nussbaum, group and healthcare practice leader at Watson Wyatt in Stamford, CT, says companies need 15% enrollment to begin seeing ROI that is required for building CDHP infrastructure. Companies with at least half of their employees enrolled in a CDHP have a two-year cost trend that is 25% lower than non-CDHP sponsors, according to the survey.

"We're starting to reach that [15%] threshold. Companies are working very hard to address the health status of their population and get their employees to get involved in the process themselves," he says.

Inching closer to that 15% threshold is a positive step, but health plans and employers cannot celebrate the milestone. They must continue to push to create more educated consumers and just as importantly invest in programs like waiving preventive care costs and implementing value-based insurance design so preventive care is free and those suffering from chronic disease don't face cost barriers to care and life-saving medications.

Rather than improving health and creating better consumers, plans that simply shift costs will result in sicker members down the road—and that will cost the healthcare system even more.

Les Masterson is an editor for HealthLeaders Media.

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