Consumer Engagement in Health Care and Choice of Health Plan: Differences Among Millennials, Baby Boomers, and Generation X Have Implications for Plan Sponsors

April 2017, Vol. 38, No. 6
Paperback, 12 pp.
PDF, 975 kb
Employee Benefit Research Institute, 2017

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Executive Summary

The EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) is an online survey that examines issues surrounding consumer-driven health care, including the cost of insurance, the cost of care, satisfaction with health care, satisfaction with health care plans, reasons for choosing a plan, and sources of health information. It is co-sponsored by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates, Inc., with support from seven private organizations.


The 2015 survey was conducted online Aug. 4-21, 2015, using the Ipsos’ consumer panel. Over 3,590 adults ages 21-64 who had health insurance provided through an employer, purchased directly from a carrier, or purchased through a government exchange, participated in the survey. However, most survey participants (82 percent) received coverage through an employer. The sample was weighted to reflect the actual proportions in the population ages 21-64 with private health-insurance coverage. Key findings on generational cohort differences:



  • Millennials value and are more satisfied than other generational cohorts with aspects of plan management that are directly within a plan sponsor’s control. More than other generational cohorts, millennials are satisfied with the process of enrollment, including the information available to help understand health plan choices. Further, millennials are more satisfied with the availability of affordable health plans at enrollment and their personal financial experience of out-of-pocket costs. Millennials are slightly less satisfied with health system features that plan sponsors have less control over, including quality of health care received and doctor choice. This is an issue plan sponsors may engage their insurance partners to address.
  • Millennials are more engaged than other generational cohorts in health care choices, including some that are costly for plan sponsors. At enrollment and when engaged with the health system, millennials report higher rates of specific behaviors that contribute to more engaged health care consumers. However, they are also more likely to request a brand name drug over a generic. Plan sponsors may want to experiment with targeted ways to lower plan costs among this subset of their participant population. Millennials report greater engagement with cost-conscious behaviors (e.g., seeking the cost of a procedure before receiving services) that many plan sponsors encourage through their health plan design and participant education.
  • Plan sponsors may have more leverage to encourage millennials to stop smoking. This research shows that millennials have the highest rates of regular exercise and normal weight, yet paradoxically are more likely to smoke. Given the higher overall engagement rates summarized above, plan sponsors may want to experiment with plan design and education to decrease the rates of smoking among the youngest generational cohort.