Figure 21 Figure 22 Figure 23 Figure 4 Figure 3 Figure 16 Figure 17 Figure 5 Figure 7 Figure 2 Figure 20 Figure 6 Figure 1 Key Findin Figure 18 gs Figure 13 Figure 12 Figure 15 Figure 8 Figure 11 Figure 14 Figure 19 Figure 9 Figure 10 2019 CEHCS Key Findings Key Findings Key Findings Key Findings Key Findings Key Findings Discussion of Metho Respondent Profile Overview dology Satisfaction With Satisfaction With Health Health Plan Plan/Length of Time With Current Respondent Profile Respondent Profile Health Savings Accounts: Q Satisfaction Traditional Product With Health Car Owners With uiz e Choices: Satisfaction With Health Plan Use of Account Using Health Sa Growth of Consuvings Accounts mer-Directed Health Plans (CDHP) and Choice of Health Plans Use of a Primary Care Physician Use of Account Search for Health Care Cost Information Use of HSAs Overall satisfaction remained lower for high-deductible members compared with the traditional plan group. Health Information: Con Views on Primary Care Pro sumevider’ r Research Patterns s (PCP’s) Role Use of Account Important Aspects of Health Pla : Generations n Cons Health Information: Con V Important In ie 2019 umws on Pr ,ers there were m conti ost nued to Aspects of Health Pla sati imar sfiebe d wi a th hi y Care Pro gher the eas sati e sfacti of sume select on w ing a ith vider’ r quali Research Patterns plan n ty and of care f s (PCP’ informa or the tion tradi av s) ai tilabl onal Role e,plan and owners least High High The The two high leadi -deducti ng ways consum ble group was ers sus igni ed ficantly their ac more counts like were to ly to hav pay e a for choi current ce of two expense or three s and plans. save for health Hi Two gh-ideducti n three v ble iewed plan owners t their health ended savings to be account the mos (Ht SA) know as a ledgea long-ble term about savings he alt veh h isa cle v that ings accounts can be us (H ed SAs for ); High High Plan A majority rolled over money in unspent funds each year. Enrollment At least 7 in 10 in consumers High-Deductible had a primary Health care p Plans Cont rovider High . inues to Grow High CDHP/HDHP Availability A quarter nationally tried to find health care cost information; most of those did find information. High-Deductible Health Plans (HDHP) HD sa Nearly 6 i Ha Attitude HP tisfie vi Enrollees ng a d wi n 10 G s good th Tow the en ard network Ex num National Xers hibit More Primary ber viand e of wed health eas Tradition Care Dif Cost thei y access plans r hea -al Conscious B fer lth to to by Generational choose sa Ded care were vings uctible account from. ehav consi ior (H dered Than SA) Cohort as Traditional “v a e ry chec important king account. National Plan Enrollee ” by 7 Tradition in 10 nati sal onally. Deductible Indiv Tcompared wi radi idti uals onal wi plan th th HSAs mem highare using -bers deducti were ble the ac less grou likel ps. coun y than ts in consum a vari ers ety of ways. with high-deducti Nearlyble 40 p perc lans ent to ask for a generic drug care expenses in retirement. nearly health 4 care in 10 p costs assed in r National eti the reme HSA nt. qui Tradition A z.similar al sha Ded re uctible expressed interest in an automatic investment feature for Ded thei uctible r Clos Boom Mem Tradi e ti bers ers wer to onal 6 of in 10 users and tradi e more i hiti gh onal -deducti ncli were plans ned comforta ble to were fiplan nd som ble telli importance i holders ewhat ng vless thei alue n thei r p like d ri a ly ma r p to do good ri ry ma doctor network any ry doctor of about the and know li a staccess e ny d ing health acti all ons to the health issu tha other en . Half hi care a gh medi fou -deducti cal nd s mos icare t t bletha t T 15th he longer Annual a mem Consumer ber was with thei Engag r health ement care plan, in Heal the more th Care satisfie Sur d they vey appeared to be. National Traditional Deductible National Traditional Deductible National Traditional Satisfaction with out-of-pocket (OOP) costs continued to be much higher for the traditional plan group than Si The x in perc ten ventage iewed thei (n=1,20 of t r health he po 1) pulation sav (n=858 ings )account with a (n=1,21 hi (H gh SA) 0ded ) as a uctibl savings e has account. continued (n=1,20 1) (n=858) (n=1,210) One in six traditional plan owners with a choice of plans had the option for a high-deductible health plan instead of a brand-name drug or ask their doctors to recommend less costly drugs. were using them to (n=1,20 pay for c 1) urren (n=858 t out ) -of-pocket (n=1,210) expenses and/or saving for health The high-deductible group was more likely to look for and find health care cost information. ithey unu iplan mportant mportant sed rec mem HS ei t ve t be A hat o from other fu rs. thei nds at thei r c r d hoi the octor ce pro end of has vhealth iders. of a the compr plan. year. ehensive view of their care. (n=1,017) Those Individuals Mosin t in an div HD iduals HP Are wer had Most e more a pri Satisfied mary care pr likely than With those ov Plan ider. wi Selection Ov th tradition erall, 72 and Least al perc cov ent erage to say that they Those with account tenu (n=1,20 res of 1) more than (n=858) one (n=1,21 year were si 0) gnificantly more likely to a (n=1,20 nswer 1) the (n=858 ques ) tions (n=1,210) (n=999) (n=721) The for fihi ndings gh-deducti presble ente mem d in bers the . attached Satisfaction chart With pack were Aspects of Health derived Carefrom the 2019 EBRI/Greenwald & Most health plan The Choi Consumer Engagement ce and access satisfaction iwere s n Hea im lth ilar across the Care Survey three (CEHC plan S) types, is a though high deductible scored to increase. In 2019, 15 percent of privately insured adults had a plan I(H ndi DH vidu P)/c als onsu who mer felt fi -dinanci rected ally health secure plan tended t (CDHP) o .be thinking longer term about those funds for savings and car Gend e expen er ses in rHow etirement ( much do Figyou ure agree 17). One or disagre -third wer e with each e Ethnic using Backgrou their of the following HSAs to nd mini statements? mize One in three (29%) of financially secure individuals and about 1 in 6 (18%) individuals in good to fair/poor had repor checked ted hav wh in How g ether a pri strongly the mary care pr plan do you woul Do you agree ov d cov ider have a or disagre er (Fig car primary care ure 13 e or e with each ) med . Those ic provider ation in of the following HD (55 HP or PCP? perc s ent statements: HDHP vs. 42 Employme correctly. nt Status Incidence of CDHP/HDHP in national sample Satisfied With the Number Of Plan Choices Education Marital Status However, as third most important, traditional plan users focused Employer on Size out (Among those employed -of-pocket costs when full or part visit time) ing a sliAre you ghtly lower. In offered the last a year/Since choice of health you joined plans?/How Extr your emel current y/Very many different health health Some plan, did what you plans do did any you of have to choose the following? from? Associates Consumer Engagement in Health Care Survey (CEHCS), an online survey that retirement than those who were financially insecure. that In the was last asso year/Since ciated wi you th either joined a health your current reimbursement health plan, did arrange you do ment any of the following concerning your 15% of privately 8 in 10 Baby 9 in 10 How important were To the best of each your of knowledge, the following are aspec each ts of of a the health following plan statements in your choice about of your health current savings plan? survey of privately insured adults conducted by the Employee enrollees taxes health and/or see it as to a pay for a m n investment acc ix of sho ount rt-.term and Has lon HSA; g-term health CDHP care expenses. Thirty How strongly do you agree or disagree with each of the following statements: perc wer Tradi Certa ent e tional sli traditiona ghtly in plan Aspects more owners l); ch likely ecked of H who than ealth Plans are the those not quali offered a in tradition ty ratin Are More Important hi g gh of a d al -deducti heal octor th ble plan or h ps to lan conti ospi hav Than tal e nued to before a ri rec se.eiving Male 47% 46% Nation 51% al Only, Has Wa hitPCP e/ 2019 CEHCS Funders (CHCS/CEHCS: 2005 –2019) Em doctor ployed , ful whereas l time high- 77% deductible p 75% lan users focused Covered 82% Percent on by age lower costs Empl Yes oyer of premiums. OVERALL SATISFACTION When it comes to choosing a health plan, most people were satisfied Some high In school the past or two years, have you tried to find the cost Ma of rrhealth ied care services that 57% you needed 55% before 62% Knowle (HRA) The EBRI/Greenwald or h dge About HSA ealth savings accs Is ount Lacking (HSA) Nation , col al prescription (lec n=1,201 tively ); Tknow op Sel drugs? Seven f-em n pl as c oy Shown ed ons & Associates witumer h - 62% 58% 73% accounts (HSAs) True or False? examines issues surrounding consumer-driven Stron hea gly Agree lth care, includ Somewhat Agree ing the cost of insurance, the National (n=1,133) percent were using them to reimburse themselves for out 58% -of-pocket expens 31% es when 89% 6% 8% How do <0. you 5% view this account? National Only; Has a PCP 4% 4% 3% car pri e ( mary care pr 45 percent HD ovider HP v(s. 77 36 perc perc ent ent vs. traditiona 70 percent) l); ch . Not ecked Cau surpr casian the isingl priy, Baby ce of doctor’s visits, % Extremely/Very Satisfied Benefit Resear National ch Institute (EBRI) and Greenwald Traditional & Associates, an High Deductible Strongly Agree Somewhat Agreeconsidered these Others les Fem s ale 53 54 49 no employees you actually got that care?/We Satisfaction Satisfaction re you With With Perc able Aspects Aspects entto age find of Health of Health Yes the information you Plan Plan were looking for? Employed part time 6 8 4 with the ease of selecting a plan and the information available to insured adults individuals Boomers directed health plans (CDHP) (Figure 1). Thirteen percent had a high- 2018 2017 Ease To of the best Selecti of ng your knowledge, How are you was Overall Satisfaction using one of your the account? plans True With Health you were offered, Care Plan False but did not take, a Don't Kn Benef oplan with w itWal a let high Not married, Millennials (n=267) Has HSA they n cost of care eeded the mon , satisfactio ey.n One with -quarter health wer care, e usi sati ng sfa them to ction wi pay for th 47% hea immed Fina lth ncially care iate plans, or Finarea ncially 44%sons for 91% (n=1,201) Traditional (n=858) CDHP (n=85Hig 8) h Dedu HDHP ctible (n=1,210) (n=1,210) med HS Boomers wer A owne ication, or o rs e more and th ther serv liose kely ice more than before Gene like rec ly to ration eivinbe elig g ca Xers re (4 an ible d 6 Mi perc for an HSA were llenn ent ialHD s to HP hav vs.e 35 a percent I am comfortable telling my primary 8 8 8 National (n=1,113) Traditional (n=805) High Deductible (n=1,096) Traditional (n=806) Hispanic 14 14 12 61% 30% 91% independe When it comes nt research to the firm. ir h The ealth p surve lan, Sty ron has bee gly most Agreepeop n Somewhat Agree cond le thought ucted that Fewer than I view my HSA as a long-term savings vehicle that I can Hig Age h school graduate 21 Has HSA; 22 CDHP ( High Sat n=568 10 isfact )ion by living Plan wit Tenure h partner a deductible Health Plan ?/Did the high-deductible Very I Gen Xers (n=351) plan that mportant you were Some 2 to offered 9 what Impo but rtant did not take also 7 aspects very include 7 a savings or 6 ded them to uctibl he e hea lp them und lth plan (HD ersHP tand Tra ) that dition thei was al r health pl (n=85 not 8asso ) an ciated choic High Ded with esucti .either Howeve 54% ble (n=1 an ,2 r, 10) we had had re s a a ati pri plan sfie ma 39% as d ry soci wi care Trad. th ated the pro eas 93% wi vider th e an of Not employed, 2 2 2 Secure Insecure 57% 55% 35% 35% shorter How -term important were expenses, and each 18 of perc the following ent were aspec using ts them t of a health o invest. plan Indiv in your iduchoice als who of your current plan? 32% 35% 67% doctor about any health issue I may haveExtr Extr emel emel y/Very y/Very Some Some what what traditiona primary care pr l); talked ov to ider their (82 doctor percent s about Boomers; 74 other treatm percent ent options Gen Xers; and 65 costs (37 percent choosing a plan, and sources of health information. The 2019 CEHCS was conducted within the Any more oneDo Can kn you use f Open owledge or typically he a alth car Healt roll money e ab h costs in m le Natab iony a ret out HS l (n=1, in ireunspent ment ( 201)As n=568) than funds over from those in year traditional How pla do ns. you view this account? Consumer Engagement in 27% 25% Health 48% Boomers (n=248) 69% 25% 94% looking for work African-American/ the following asp account ects were or fund vthat ery or som you could ewh use at to pay important: your health care the expenses? HRA or HSA. Millennials (n=51) Gen Xers (n=57) Baby Boomers (n HRA selecti =27) or H ng SA a plan and the annually since 2005. The CEHCS provides reliable national data on So21 me sati to coll sfa 29ege ction fell when 16%22 Hig exami h Deductini bl 17% eng (22 n=1,1 the avai 59) 13% 12 labi Top S lity ix Shown of aff Divorced ordabl or separat e hea edlth 8 8 7 53% 10 to 49 34% 9 87% 10 8 described themselves as beinY g es, Abl financ e to ialFind ly secure wer No, Not Abl e fare to more li Findkely N to o, D say idn't Try they are OOP RX COSTS somewhat QUALITY HD perc HP vent s. Sav 31 Mi ings A perc llenn cc ent ial ount 32% s). traditiona , l); talked to their doctors about prescription options 12 and 15 High Ded. 5 N Nat atiional onal Has HSA 43% 49% to year or do you tend to zero out the account each year? Blue Cross and United States between Aug. 26 and Sept. 20, 2019 through a 20-minute 6 in 10 internet survey. The Only 58 percent of HDHP enrollees and 30 percent of traditional 4 in 10 5 in 10 To Pay for Out-of-Pocket Expenses Incurred I am comfortable telling m Tra y p dition rima ary do l (n=858) ctor Black < 1 year 27% 1 - 2 years 21% 3+ years iv nforma s. 74% 52%of tion Gen avai Xers lable to them % Extremely/Very Satisfied I am int 55% erested in a type of automatic investment f49% eatur 66% e 35% 26% 84% 92% % Extremely/Very Satisfied Homem netwo ake It is r rk impo of health care prov rtant to m 6e ( (n=1 n=1 that ,,14 165) 8) my doc 5 tider or s, easy a 4 ccess to health care, plans and Good Net the number o work of Phys f hea icians lth Tradit plans ional P to choo lan With Ch se oice from ( of Plans Figure (n=451 5). ) Regardless of Which Type of 39% 43% using Qua their lity HSAs to of Health save for health care ex Millennials pense (n=2 s i 66) n retirement 56% 39%(51 percent vs. 10 37% 93% Trad the 30 e or to Allowed grow 44 busines th t s o of Roll consum Over 37Unsp erent -dri Money; ven 37 hea Had lth Savings plans 36 Ac and count hi W f g id or h owed at -deduc 45% tible 1 41% 1 86% 1 costs (36 percent HDHP vs. 29 percent traditional); used 50an to 49 onl 9 ine cost-trackin 19 g tool 20 17 23% 38% 61% The Cost I Pay out of about any h Thi ealt s Year h issu or e I in m th aye Nea have (r n=8 Term 71) 70% 27% 2018 2018 97% 2017 2017 for my unused HSA funds at th4 e end of each year 5 (n=98) 4 knew impo that rtant: they can use their HSA Blu No e Shield Association nati pla onal n enor bas rolleee s kn sample w Don’t ew t Kno hat w as drawn the if y could use from Dynata’s their HSA to online pa panel of y for internet user vs. 65% of s who Millenni have als knows me and my medical history Lower Satisfaction With Health Care Costs Drives Differences by Plan Health Insurance Plan TheyT T radi radi Hig t tiih on on De al al d. (n=1,210) Gen Xers (n=351) Very 28% Asian/Pacific Very school and Hospitals 48% 42% 90% CaNo re I Receive Least One Year Care Survey 22% 44% 34% perc low ent) out or to -ofbe -po in cket vesting cost their s, prescriptio account funds n drug in stock, covbonds, erage, or mutual low funds — Retired 8 8 8 No prov Tradit Ovided ional eral Poc l, most (n by t =85 ket he 8)for people heal My th plan agree (25 d (perc either ent strong HDHP ly v or s s. 17 omewhat) perc High ent Deductibl that tradition they ar e (n al) =1, ; e 21 dev 0)9eloped a 10 8 45 to 54 25 25 26 Single, never married 26 Trad. financiall 28 HDHP 22 y 46% 54% 67% 64% 50 33% 0 t25% o 1,99987% 92% 14 23% Trad. 52% 13 57% 15 health plans and Off thei ered HDHP r i ( (n=8 n=8 mpact 16 32) ) on the behavior and attitudes of to pay for hea 67% lth 70% expenses in 45% personally Boomers (n= Important 247) Islander OVERALL Importa SATISFACTI nt ON 63% 31% 94% Have 43% 18% agree he It alth is im d por to parti care e tant to m cipate xpense e that my in s pri in res ma retire ear ry doctor ch me surve is nt (Fig ys. Adul ure 16 ts ages ). On ly 21-64 39 pwho ercehad nt health insurance through Informa Type tion Av 28% ailable National (n=1,148) TI hroug am inteh rested My P inlan investing some of my HSA money in 30% 55% 35% 90% altho 42% ugh the proportion is still small (21 percent vs. 7 percent). ? Network of health College graduate 25 24 39 budget prem Presc to iums, ript manage h ion Drugs simple eal to th unde care expen rstand, ses (2 and 1 perc specific ent HD cov HP 15% v erag s. 17 e percent traditional); or 15% comfortable telling their primary care provider about any health issue % Extremely/Very Satisfied Sa Ot ving for Many her Health People Care Exp Have ense 2 a s in Choice Retiremen 2 of t Health 1 Plans 51% 10% 38% retirement National (n=1, Hi Hig gh h De Ded d201) .. 21% 32% 53% Consumer-Directed 57% Health Plan 17% (n=487) 9% 65% 55 to 64 22 22 25 Household Income Consumer-Directed Health Plan (n=568) aware of all the o stocks, ther bonm ds, edical or mutual funds ( care that I n=568) 2,000 to 4,999 8 8 8 50% High43% Ded. 93% health to care Help Y consum ou ers. 38% High Ded. 39% 40% Good netwEasy-to-Access Health Care ork of physicians and hospitals 69% Good network of physicians and hospital 59% s 62% 73% 69% 68% 29% 97% It is of impo HDHP rtant ten o mrollee e that my s and 13 primary doc percen tor 35% is t 59% of traditional plans 36% Ot 30% he 71% r en 89% rollees 3 3 2018 2 2017 an employer, purchased directly from a carrier, or purchased through a government HealthEqui exchange ty, Inc. Most people wer 36%e satisf ( (n=1 n=1ied wi ,,16 196) 9) th the quality of care, choice o 36% f physician 14% , Millennials (n=265) care providers decli that ned a medica they may hav l procedure e, that it is important beca 53% use of costs that their (25 docto percr ent know 38% HDs HP them and vs. 16 percent 48% 14% secure enrollees 86% 35% 16% SoY me ou include post Can -gr Uaduat se d in Your e the Healt p h lan (Figur Traditiona e 8) l (n=8 22% .15 Th ) e provider network and access About two receive f -thirds rom of i other pro nd Naividual tiov nide al (n=1, rs (n s =863 201) reported ) that they have a choice of at (n=1,01736% ) 57% 13% 34% 91% 51% 16% (n=999) (n=721) 13% 50% Understand Your 30% 3 4 4 13% Chi aware ldren of in Ho allus the ot ehold her medical care that I Less than $20,000 6% 8% 1% 5,000 to 9,999 6 7 Trad. 7 Overall, 61 percent reported using the HSA as a Gen Xers (n=345) savings account, 25 percent as an 54% 55% 31% 48% 47% 95% and access to care, and the findings did not vary much by plan type. work Eas kn H ya -ew t to ving an HSA has -access hat HSAs heal te h m care pow can be in ered me to mak vested e better hin ealtmutual funds. h 68% Easy-to-access health care 9 in 10 health 70% traditiona were Savings A drawn l)cc (Fig ount random ure 10 to Pay ). ly How from the ever, fewer Dynata than sample for thi one-half said t s hey base ha sample. d engaged in This sample w any of thas stra is tified by their medical history personally, and that it is important Hispa that nictheir primary 31% 29% 46% had asked for a 57% 2019 2018 2017 least to he two alth care were health plans ra (Figure nked 6) h . igh Despi er in te importance the fact that than satisfa lower ction 19% 19% 11% 42% 53% Health Plan Choi recei cesve from other providers 37% 23% Minimizin Tradition g You al (n=858) r Taxes Boomers (n=248) Low Out-of-Pocket Costs When 30% 35% 13% 65% 57% 31% 96% Self The It -Employe is 2019 impor 53% tan d surve t to m y e ca of that re an 2,068 i 29% my d Hi fin g do h De an ctor ndividu cia duct l know dibl ecisio e (n=1 s m als ns (n= ,1e 82) was 568) conducted using investment account, and 18 percent as a checking 46%account (Figure 18 39% ). Nine i85% n ten ? Easy access to health None for Medical Expenses 55% in 56% 60% $20,000 to $29,999 25% 4 4 2 25% Approximately 90 percent (or more) were satisfied with 10,000 these as or Savings Account morepects of 24 individuals 22 High Ded. 61% 28 14% 14% 44% 48% cos car t-con e prov scious ider behav is awa ior re of for anythi all of the ng other other med than ic ch al care ecking that wh Offered H ether they r DHP, the ecei W heal v ith e Account th plan would 66% 51% 31% 38% 18% 97% generi 15% 89%c drug 17% Graduate degree 18 15 31 Lower cost of premium 64% Lo gender, w out-of-pocket age, regi costs whe on,n income, you see the17% and race. In 68%previ 17% ous years Yes , the survey was fielded using Ipsos’ Yes 14% 14% 12% related to the numb Ye er of s health plan choices was lower among National Rura 13% l Electric and I Typically Roll Over my medical history personally (n=869) OO ACC P CO ESS STS cost of premiums or low out-of-pocket costs. You See the Doctor 21% N Nat atiional onal December 2019 Retirement 13% reported rolling over unspent HSA money each year. High Ded. (n=1,210) 10% plan enrollees Yes Yes 9% 10% 9% 58% 10% care 32% Dynata care (Fig /Re ure 2) sea.rchNow’s In contrast onli , many i ne res ndiv ear iduals ch panel between in CDHPs and 35% Offered H HD Aug. HPDHP, s we 26 and No re Account doctor 40% 63% 34% 27% 74% 90% 5% said inst they 7% ead of are usi a 9% ng brand cov One (Fig er ure 14 care or ). How med ev ication er, 19 it was s. less 19 important Millennials that 18 (n=2 10% they see 66) $30, 000 70% their to pri $39mary ,99915% 6 6 5 WhI en save u it cam p to the a e mo to unt fals of mye expe statem cted outen -of-ptock s, only et 44 22%percen Don’tt 32% know of HDHP 846% % Extremely/Ve % Extremely/Ve 9r ry y Satis Satis 78% fied fied 7 17% 17% The Ease Cos of t I Getti Pay ou ng t 72% ( (n=1 n=1,,16 142) 2) 55% of HSA pan Money in Unspent el. There were Funds over 1,200 national sample completes, 537 CDHP completes (183– nati16% onal; To Pa HDHP y for It is enr a import Mol ix o lees a f n Short-Te t t than tradi o me rm that and I see Long ti onal my o -Te wn rm plan enrollees ( 89% Figu Pres re cri 5) pt, ioHDHP n drug coverage 62% No 14% 85 85 88 15% 31% 46% Cooperative Offered 77% 11%9 in 10 were Traditional (n=858) medical expenses for the year in my HSA 15% (n=297) Gen Xers (n=351) 7% 67% 2018 2018 2017 2017 dissatisfied with the cost they pay out of pocket for prescOf ription 11% fered H 41% drugs 11% DHP, Do (29 n’t Know agreed t 43% hat thei : r HSAs nam 84% eto save for 11% 32% 24% 38% 11% No care provider every v 9111% isit and that 90 the docto 91r’s office has all the doctors of an My Own Appointm Pocent ket OVERALL SATISFACTION Sept. 20, primar 2019.y All care res prov T Tradi radi pond ider t tiion onal al ev ents ery t w ime ere between the ages of 21 and 64. Pres en Two It cri rollee ispt im io por n dr tan s ug and t to m coverage Each Year e 21 that Hea p 16 I se erce lth e Car my nt own e Exp of t 16 pri enses raditional p mary 66% 14 lan enr $4 ollee 0,000 ts o $4 kn 9,ew t 999 hat 6 9% 7 6% 5 9% 12% (n=970) (n=698) (n=985) Prescription Drug Coverage enrollees were more likely than tradi 18%tional HDHP, plan e With 64% nrollees to report 30% 94% 354 Gen – oversa erally, mpl traditional plan e e), and 673 HDHP National 28% (nnr =1, com 14 47% ollee 1)Boomers (n= 64% ple s and tes 2 (47) 160 HDHP 33% – nati en 27% onal; rollee 80% 513 91% s rank – oversa ed mple). The national Low A out ccount -of51% -pocket costs when you see 35% the 86% 57% 48% 41% Refused 31% 42% 79% 1 ? Lo Tr Trad adw out .. 1 -83% of-pocket <0.5 Not surprisingly given where they are in their lifecycles, Baby Invest Boomers wer ment Account e most likelyAs 60% 46% sociati % Extremel 68% 49%on y/Very Satisfied ( (n=8 n=815 29) ) • They are 25% health comforta care ble telli expense ng s perc I expect my HSA ent) and adm other inistrato heal r to prov th id car e the e same (43 le perc vel ofent) (Figure 3). This may acco 14% unt 25% In that addition, they n wh eed at one l care en pro it ca vider e me oca very to presc ttion. ime (n The ri =869 ption )degree drug 7% use, thos to which e they ag 24% in an HD reed that HP were more likely than W for ith My Other a Doctor enrollees satisfied with: 13% (n=1,210) $300 to (n=1,20Na 1) tional (n=1, (n=858 201) ) 22% Account it was not true that anyone can open an HSA. 23% Similarly, on doct Not or 36% Offered ly HDHP 55 42% Three 4 4 5 $50,000 to $69,999 13 39% 12 37% 2018 14 29% 2017 LoweIf r cost You of Leav premium e Your Job, 60% that inve Av stment guida they ailabhad ility of nce a achoic nd advice e tof hat I re hea ceive lth from my plan (Figure 6). Retirement Twenty-two or Savings percent Plan Through Employer sample i these s asp weiects ghted of health care in by gender, age, the income, sa12% me ethni order city , with one , educati 32% on, and 44%regi thei on r p to re rima in rflect the ry eti vcare s. reme 29% pro nt of vider Reim to view bursing HSAs Yoursel as sf for avin Out gs Hi Hi -g g acc of h h -Poc De Ded dount .. ket He s, wh alth ile Millennials were most likely to view them as costs for the ov 8% erall difference in satisfaction by plan type. 17% 17% Region When HeaNeeded lth Care 16% those after see with tradition ing their doctor al coverage , they make he Traditi to onahav l (n=809 e ) asked althier lifes for a gener tyle chic oic drug es and instead rely of a brand H High igh ? Ded Ded Qua .. lity of care 22% Millennials 58% 35% (n=262) 57% 28% 86% $999 25% 56% 63% 27% 52% 22% 32% 55%knew 84% that it is not 77% true that if they The national sample is weighted by gender, age, income, 14% ethnicity, 401(k) provider (n=568) 30%Don’t Know if Offered HDHP Trad. You Lose Your Health 30% 7% 36% 44% 35%47% ( (n=1 n=1,,18 183) 5) 24% 37% Retirement Afforda I prefeble r Ac a doct count Hea or lth or ’s IRA office that has all of the 12% percent of HSA enrollee Tradition s and al (n=858) 30 percent of HDHP enrollees knew Expens7% es When You Need the Money Simple to understand 51% Four o of HD r more HP enrollees reported 2 that 2 they had 24% 2 two he$7 alth pl 0,000 30% to ans $99,to 999choose 19about 46% any 18health traditional issue19 plan investment accounts (Figure 19). 6% Simple to understand 59% Yes 80% 79% 87% exce I prefer ption: a d Lower Cost of oct Tr or aditional plan en ’s office that has Premium all of the rollee Gen Xers (n=335) s reported that low out-of- actual proportions in the populati5% on. 61% 25% 48%35% 73% 96% name ( on themselv 43 perces ent more HDHP than vs. 29 their perc primary d ent tradition octor al) to or make decisi to have asked ons about their doctor to Because of the tax advantages, I choose to maximize my 2 in 3 South 36% leave their 35% job, they lose thei 34% r Savings Account and the ? Choice of physician doctors that I need all in one place ?Prudenti Prescription al Fina drug ncial 23% 50% 73% Plans 4% High Ded. High Deductible (n=1,180) 31% 32% education, and region to reflect the actual proportions in the • It is important vs. 10 enrollees 4% % tha of t thos theie r d who octor doctors that I need all in one place (n=840) Boomers (n= 38% 239) 33% 71% Ythat es from, it is not t compared rue twi hat if they 52% th 17 percent leave 47% among their job, 68% tradithe tional y lose 20% plan e Checking Account the nroll HSA ee46% s. 66% H Ch SA ec cont ked ributions Ch first, be ecked t fore maxim he 3% iz Ch ing ec my con ked the tributions Talked to Doctor Talked to Doctor Used Online De 18% veloped Declined All/Part High Ded. (n=1,210) Yes No Adults (ages 26 or older) in Household 5% 19%12% $10 21% 0,000 to $155% 433% 9,999 19 20 26% 17 Satisfaction Increases With Plan Tenure Boomers are more rec their po omm cket medical end cost a l Money ess costly car s for doct e lea in It ned presc or’s much ription visit more s drug were toward (31 more perc somewha ent important. No HDHP t agree vs. Of 22 in l perc g esse wient th r tradition 20 HSA and al) th e 21money in it 13 Saving to Pay for Immediate or Short-Term High Deductible (n=1,210) 21% 14% 61% 3% ?coverage Access to care West 24 26 23 to savings plans such as a 401(k) or IRA (n=568) knows them are fi and nanci thei ally r medi insecu cal re Whether Health Quality Rating of Price of a About Other About Rx Tracking Tool to Budget for of a Medical 39% 26% Despite the fact that only 18 percent viewed the accounts as investment accounts, I Typically Zero Out My 19% 33% And 28 percent of HDHP enrollees reported that they had three popu and th lae m tion.one The y consum in it. er-directed health plan (CD like HP) ly to ha and vhi e a gh- No 48N Nat atiional onal 53 32 individuals OVERALCHOICE L SATISFACTION Health Care Expenses (Fig those ure 11 statem A) ft.e Again, r seeing ents my thoug th pri an mary st h, rfewer on doc gly tor, agree than I makeone ing.- hal Baby f repor Boomers wer ted doing e much so. None 3% 3% 1% $150,000 or more 22 19 31 Satisfa importance ction with was heal low co th Micov llennerage ist als of p (n=404 did, how rem ) Millennials iums 65% ev (n=2 er, whe 56) 35 incr n sele ease t cting he lon a pla ger n. I save up to the amount of my out-of-11% pocket medical 21% 48% 69% Plan Would Simple to Underst a Doctor Doctor's v and isit, 56% 69% Treatment Opt 32% ion 23% s & Cost 88% s 92% Manage Health Health Care Procedure Due 58% 38% 96% Not Offered history personally A1% fter seei 1% ng my primary doctor, I make 9% Savings Account ( (n=1 n=1,,17 177) 0) Investment Account Mi Checking Account dwest 21 None 19 26 77 percent Account Each Year either strongly agreed (32 percent) or somewhat agreed (35 percent) % Extremely/Ve % Extremely/Ve that r ry y Satis Satisfied fied UMB Financial ? Low premiums healthier lifestyle choices (diet, exercise, sleep, primary care provider health plans to choose from, compared 18% with 17 percent of 53% traditional 71% expenses in my HSA Asked for a Generic Dru rather than putting money into ot gGen Xers (n=337) her Asked My Doctor to Asked for a Brand-Name more likely than Millennials to strongly agree9% that they ar 20% 17% e comfor 29%table 56% had a choi73% ce OVEof RAL at L SA leas TISFt ACTION Cov deduc er Care o tible r hea or H lth ospital plan (HDHP) Medicat ion samples are , or Options & wei Costsghted by gender, Expenses Expenses to Cost someone had been enrolled in their plan. For example, among HDHP HDHP Traditional High-Deductible Health Plan One However, HDHP healthi 22 en er lirollee festyle choi s 23 reported ces Offered HDHP, that low 23 No prem Declined t iums o answe were r •5 It is imp 2018 2018 ortant 5 tha 2017 2017t their p 6 rimary National (n=1,201) Inv Ov estin erall g A My Choi Sa ccount tisface cti Fund on of s in Stocks, Nati Bonds onal (n= , or 1,119) 18% 22% 60% T Tradi radi Gen t tiion onal al Xers (n=481) 74% 26 44% 34% 78% % Extremely/Very Satisfied they view the savings acc plans ount su as ch str as a 401( ess, a lon etc.) ( g k)- or term sav n=8 IRA 42) (n=271) ings vehicle that None of the they can use for Above health than Millennials and 15% Boomers (n=244) 16% Northeast 54% 18 20 70% 17 Instead of a Brand-Name Recommend a Less Costly Drug Instead of a Generic Medication Before Other Service 61% 69% 30% 23% 91% 92% Num plan e ber Have No Choic nroll of Hea ee lth s. Overall, e Choice of 2 Pla 32 percent of tradi ns Choice of 3 Pla tional 18% plan e ns nroll Choice of 4 o ees r two Have a Choice, health plans Gene telling t ral HSA lyhei , v Funds ery r pr few people imary Can Be care prov searider ch for about healany th car hea e co lth st issin ue that formation they may . Ov 21% erall, only abo 7% ut enrollees, the percentage extremely ( (n=8 n=838 32) ) or very Acc satis ountfied increased from 35 Specific Coverage Included in ? Tr Tr Si ad ad mple .. to understand care pro 59% 65% vider 62% 70% is awa 2018 re of all 2017of With My Health Doctors Care Mutual Funds age, income, and ethnicity. more important than low out-of-pocket costs when selecting a Two 60 57 66 Traditional (n=858) carI re e co ly osts n myse in retire lf, m I Receiv ore th ment ( ed C an m are Fig y pure 20 rim Bef ary do ore Care ).ct One or, -half strongly agree Gen d ( Xers. 21 percent) or I contribute the same amount as my annual hea13% lth 52% 22% 42% 65% 94% Boom Drug ers (n=307) 82% Prescription Drug 18 Drug Inv Plans ested to Employee in Mu Choos tual Fu e nds Benefit Research Institute Gr More Plans eenwald & Ass but Don't Know ociates have, that it is important that Traditi their onal (n doctor =791) knows them and their medical one reported -quarter I rely on that my (26 self perc they , more t ent) were han sough m offere y pri t su mary ch d an information HDHP, wi , 47% th with or 17 witho perc ut ent an acco fin 34% ding i un t and t 81%9 percent Hi Hig gh h De Ded d.. perc 2005 ent among 2006 2007 those 2008 enr the Plan oll 2009 ed in t 2010 heir plan 2011 for 8%2012 less than 19% 2013one 2014 27% year 2015 to 50 2016 2017 the other 2018 medi 2019 cal care that Trad. Plan Millennials (n=263) 20% 40% 60% 48% 47% to make decisions about insurmy m ance deductib edical car le 43% (n=56 e 66% 8) 38% 24% 81%90% 17% 43% 60% H High igh Ded Ded.. somewha plan (Fig t agree ure 9) d (.32 percent) that they are interested in having some of their HSA 42% 59% 45% 67% ? Specific coverage Three From 10 ( (n=1 n=1,,19 203) 8) 11 7 How Many Plans 2018: 41% doc 55%tor, to make 33% dec 41% Hiig sions about h Ded. ( --n=1, 210) my -- 31% 37% 29% 40% 14% 25% 14% 25% -- -- 901 D Street, SW, Suite 802 4201 Connecticut Ave. NW, Suite 620 history personally, that it is important that their pri 39% mary care prov19% ider is 42% not (Figure finding i 7)t ( . Fou Figure 12 r in ten tradi ). Those tiin onal an HD plan e HP Gen Xers (n=347) wer nroll e more ees reported likely 17% than that those they wi 46% th traditiona they 63% rec l eive percent among those enrolled in their plan for three or more years (n=862) Other Offered HDHP,1% -- -- High Ded. High Deductible (n=1,163) 35% 35% 37% 35% 72% 2018: 32% 41% 22% 31% 12% 16% Dynata money invested in stocks, bonds, or mutual funds. Only 1 in 3 reported that, because medical care included in the plan 2017: 50% 59% 39% 41% -- -- Boomers (n= 34% 39% 248) 14% 34% 39% 44% 15% 22% 58% 19% 26% -- -- I need help determining how much money I should put Four or more Washington, 3 D.C. 3 20024 2 Washington, D.C. 20008 cov aware of erage to all hav of e the other med sought such in ical care t formation hat (25 they re percent ceiv HD e, HP and that vs. 22 perc they ent traditional) ( were Figure 4) not offer . ed an HDHP Don’t in 2019, u Know p from 3 in 10 in 2017. Panel 6% 20% 26% of the intax adv to 20 my HSA v 17: an s. other inve tages 35% of HSA stments or s, they 45% expense maximize s (n=568) their 27% HSA sav 37% ings before con 16% tributin 16% g to “No “No “Don “Don “No “No “No “No t t t t t tap a a a a a ’t ’tpp pp pp pp pp pl kn kn ica li lli li low ow iica ca ca ca ca bl” ” e” ble ble ble ble ble ii f fresp h h ” ” ” ” ” a a re re re re re ve ve on sp sp sp sp sp ses a a on on on on on choi choi se se se se se no s s s s s t ce ce a n a n n in ot ot ot re re clu n n iiin n n n n ot ot de ot ot clude clude clude sh sh d sho sho in ow ow pe w w d d d n nn n iiircen n n n a a a a bo bo pe pe pe n ntag d d ve ve rce rce rce n ne ..ot ot n n n ba i i t t ta a a n n se. ge ge ge cl clude ude ba ba bad d se se seiin n ... pe perce rcen nt ta age ge ba base se.. see their own primary care prov Acc ider ount at every visit (Figure 15). and Startin to Phone: g in hav 2014, e H ( found SA 202) eligibl 659 e such s (w-it0670 h no acco information Fax: unt) w ( e202) re (21 add perc 775 ed to -ent t6312 he CHD DHP HP grou Phone: v p.s. 15 perc (202) ent 686 traditiona -0300 Fax: l). (202) 686-2512 other savings plans such as 401(k) plans and individual retirement accounts. ©201 ©201 ©201 ©201 ©201 ©2019 9 9 9 9 9 EB EB EB EB EB EBRI/Gree RI/Gree RI/Gree RI/Gree RI/Gree RI/Green n n n n nwald wald wald wald wald wald Co Co Co Co Co Consu nsu nsu nsu nsu nsume me me me me mer r r r r r Enga Enga Enga Enga Enga Engag g g g g ge e e e e eme me me me me men n n n n nt t t t t t in in in in in in He He He He He Health alth alth alth alth alth Ca Ca Ca Ca Ca Care re re re re re Survey Survey Survey Survey Survey Survey Source: Consumerism in Health Care Survey/Consumer Engagement in Health Care Survey, 2005–2019. 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