Members of “consumer-driven health plans” and ordinary high-deductible health insurance plans may be getting less information about the cost of care than members of traditional plans are getting.[@@]

Researchers at the Employee Benefit Research Institute, Washington, and The Commonwealth Fund, New York, have published data supporting that conclusion in a report based on responses from a Web-based survey of a total of 1,061 health plan members ages 21 to 64.

The final sample included 337 adults with high-deductible health coverage but no health reimbursement arrangements or health savings accounts. The sample also included 168 members of “consumer-driven health plans,” or programs that combined high-deductible health insurance with HRAs or HSAs.

The researchers note that they had to make special efforts to get a large sample of HRA and HSA holders: although about 10% of the respondents in their original sample of 1,204 adults had high-deductible health coverage with no personal health accounts, only 17 individuals, or 1.4% of the respondents, had high-deductible coverage combined with personal health accounts.

Survey participants with CDHP coverage tended to be somewhat older, healthier and higher-income than holders of conventional health coverage. Although only 21% of the CDHP members were in the 21-34 age category, compared with 29% of the traditional health plan members, 92% of the CDHP members said they were in good, very good or excellent health, compared with 87% of the traditional plan members.

About 21% of the CDHP members reporting having annual household incomes greater than $100,000, compared with 18% of the traditional plan members.

The CDHP members were also highly educated, with 67% stating that they hold bachelor’s degrees. Only 34% of the traditional plan members said they had college degrees.

Holders of ordinary high-deductible coverage ranked somewhere between traditional plan members and CDHP members in terms of education and income.

Even though the CDHP members had incomes and college degrees, only 63% said they were extremely or very satisfied with their health plans, compared with 72% of the traditional plan members.

Meanwhile, only 54% of the affluent, highly educated CDHP members said their health plans were easy to understand. About 69% of the traditional plan members said their plans were easy to understand.

The EBRI and Commonwealth Fund researchers found that CDHP members were about as likely to seek medical care as traditional plan members but somewhat less likely to fill prescriptions.

Only 12% of the CDHP and high-deductible plan members said they believed that their health plans provided information about the cost of care provided by doctors or hospitals.

When the researchers asked traditional plan members about cost information tools, 15% said the traditional plans were giving them information about the cost of hospital care, and 16% said the plans were giving them information about the cost of doctor care.

But only about 1 in 7 of the traditional plan members who had access to provider cost information had tried to use the information, while about 1 in 3 of the CDHP and high-deductible plan members with access to provider cost information had tried to use the information, the researchers write.

CDHP and high-deductible plan members also seemed to be more willing to talk to providers about the cost of care, the researchers write.

The survey “demonstrates that at least one factor crucial to the success of consumer-driven health plans – realistic, useful, accessible health-cost information – does not yet exist on a widespread basis,” the researchers conclude.

But it was not immediately clear from the survey data whether the CDHP members might have received more cost data or made more use of such data than the holders of ordinary high-deductible health coverage.