Summary
SIXTH ANNUAL SURVEY: This Issue Brief presents findings from the 2010 EBRI/MGA Consumer Engagement in Health Care Survey. This study is based on an online survey of 4,508 privately insured adults ages 21–64 to provide nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage.
ENROLLMENT LOW BUT GROWING: The survey finds continued slow growth in consumer-driven health plans: In 2010, 5 percent of the population was enrolled in a CDHP, up from 4 percent in 2009. Enrollment in HDHPs increased from 13 percent in 2009 to 14 percent in 2010. The 5 percent of the population with a CDHP represents 5.7 million adults ages 21–64 with private insurance, while the 14 percent with a HDHP represents 17.2 million people. Among the 17.2 million individuals with an HDHP, 37 percent (or 6.3 million) reported that they were eligible for an HSA but did not have such an account. Overall, 12.1 million adults ages 21–64 with private insurance, representing 9.5 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA but had not opened the account.
MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors, such as having checked whether their plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options and costs; talked to their doctor about other treatment options and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; and checked prices before getting care.
CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment, and equally likely to report that they had access to a health promotion program. HDHP enrollees were less likely to report having access to a health promotion program. CDHP enrollees were more likely than traditional plan enrollees to take advantage of the health risk assessment and the health promotion program.
FINANCIAL INCENTIVES NOT A FACTOR, BUT HIT 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 (HIT).
HEALTH STATUS IS BETTER: Adults in CDHPs were significantly less likely to smoke than were adults in traditional plans, and were less likely to be obese.
INCOME NO LONGER HIGHER; EDUCATION DIFFERENCES REMAIN: While in the past, adults in CDHPs were significantly more likely than those with traditional health coverage to have a high household income, most of the income differences were not present in 2010. However, CDHP and HDHP enrollees were more likely than traditional plan enrollees to be highly educated