Some members of the oldest federal employee “consumer-directed health plan” may be having trouble getting used to the plan.
Researchers at the U.S. Government Accountability Office have published survey data supporting that argument in a report on employee experience at a health reimbursement arrangement-based plan established by the American Postal Workers Union in 2003.
The APWU HRA plan now covers about 9,500 federal employees and a total of about 21,000 people, according to the GAO researchers.
“Enrollee satisfaction with the APWU CDHP was mixed compared to enrollee satisfaction with the other FEHBP plans,” GAO researchers write in a summary introducing the report.
Members of the APWU CDHP were more satisfied than members of new, traditional FEHBP health plans, but they were less satisfied than members of national FEHBP preferred provider organization plans, the researchers write.
GAO researchers prepared the report at the request of Sen. Max Baucus, D-Mont., the most senior Democrat on the Senate Finance Committee.
All CDHPs in the Federal Employees Health Benefits Program covered a combined total of only about 38,000 employees, retirees and dependents at the beginning of 2005, according to the GAO researchers.
But Baucus asked for the report because of concerns expressed that CDHPs might cause problems for members and drive up costs at traditional plans by luring away younger, healthier federal employees.
Members of the APWU CDHP and ordinary national FEHBP PPO plans reported similar levels of satisfaction with timeliness of care and provider communications.
The APWU CDHP earned lower marks on a measure of satisfaction with claims processing, but there the APWU CDHP was comparable to other new federal plans.
Claims-processing satisfaction amounted to 93% for FEHBP national PPO members, 86% for members of all new FEHBP plans and 87% for APWU CDHP members.
The APWU CDHP also performed about the same as other new FEHBP plans on a measure of “access to care.”
About 85% of APWU CDHP members said they were satisfied with access to care, which was almost equal to the 87% access satisfaction level for FEHBP national PPO members and substantially higher than the 77% access satisfaction level for members of other new health plans.
The GAO found the widest spread of performance on measure of satisfaction with customer service.
The 67% service satisfaction level at the APWU CDHP was much higher than the 59% customer service satisfaction level for all new FEHBP plans but much lower than the 74% customer service satisfaction level for members of all FEHBP national PPO plans.
In addition, the APWU CDHP has reported an annual claims appeal rate of 1.98 per 1,000 enrollees, compared with an average of 1.11 per 1,000 enrollees for the national PPOs, and more than half of the appeals related to problems with tracking account expenditures or deductible balances, the GAO researchers write.
The GAO researchers note that the customer service problems at the APWU CDHP and many of the appeals may stem from a flaw in the APWU CDHP brochure.
“While one page of the plan brochure explicitly states that [dental and vision] expenses count toward the deductible, another page appears to indicate that such expenses do not count toward the deductible,” the researchers write.
The APWU has revised the 2006 CDHP brochure, and it has included dental and vision expenses when determining whether CDHP members have reached their 2005 deductible limits, the researchers write.