The 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) finds continued slow growth in consumer-driven health plans (CDHPs): 9.7 percent of the population was enrolled in a CDHP, up from 9.6 percent in 2012, while enrollment in high-deductible health plans (HDHPs) increased from 16 percent in 2012 to 18 percent in 2013. Overall, 26.1 million individuals with private insurance, representing 15 percent of that market, were either in a CDHP, or in an HDHP that was eligible for a health savings account (HSA) but had not opened the account.
Unlike in prior years, when health reimbursement arrangements (HRAs) and HSAs were examined separately, HRA enrollment fell, while HSA enrollment increased. The 2013 CEHCS also found that a growing share of the HDHP market was HSA-eligible. When examining only the number of people enrolled in HSA- or HSA-eligible plans, the overall number of individuals with an HSA or enrolled in an HSA-eligible plan increased from 17.5 million to 20.4 million, a 16 percent increase.
This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. Specifically, those in a CDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctors about prescription options and costs; talked to their doctors about other treatment options and costs; asked a doctor to recommend less costly prescriptions; developed a budget to manage health care expenses; checked the price of a service before getting care; and used an online cost-tracking tool provided by the health plan.
There is also some evidence that adults in a CDHP were more likely than those in a traditional plan to be engaged in their choice of health plan: Those in a CDHP were more likely than those with traditional coverage to say that they had visited health plans’ websites to learn about their plans; attended a meeting where health plan choices were explained; used other websites to learn about health plan choices; and consulted with an insurance broker to understand plan choices.
• CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees.
