Current members of “consumer-driven health plans” may be having more trouble understanding the plans than CDHP members had a year ago.
Researchers at the Employee Benefit Research Institute, Washington, and the Commonwealth Fund have published statistics supporting that conclusion in a summary of results from a Web-based survey of 1,506 U.S. adults ages 18 to 64 with traditional comprehensive health insurance.
The researchers also included 722 members of the 18-64 age group who had a combination of high-deductible coverage and personal health accounts, such as health savings accounts or health reimbursement arrangements.
Another sample included 930 members of the 18-64 age group with high-deductible health insurance and no HRAs or HSAs.
EBRI and the Commonwealth Fund changed survey firms between 2005 and 2006 to Synovate, a unit of Aegis Group P.L.C., London, from Harris Interactive, Rochester, N.Y., and differences in the demographics of the firms’ Web survey participants may affect comparisons of the 2005 and 2006 results.
Researchers at the U.S. Government Accountability Office warned that when they conducted their own member satisfaction study, satisfaction is usually lower for new plans of any kind than for well-established plans.
Only about 1.3% of insured U.S. adult workers appear to have personal health accounts, and only 21% of those have had personal health accounts for 3 years or longer, the EBRI and Commonwealth Fund researchers report.
But the percentage of health account plan members who say they are “extremely or very likely to stay with current health plan if had the opportunity to change” has fallen to 36% this year, from 46% in 2005, and the percentage who say they are “extremely or very satisfied with health plan” has fallen to 37%, from 41%.
Satisfaction may be falling in part because the health account plan members say they are feeling more confused: The percentage who “strongly or somewhat agree that health plan is easy to understand” has fallen to 45%, from 54%, even though the health account plans have been on the market 1 more year.
Advocates of consumer-driven health care say health account programs can give patients the financial incentives and tools to do a better job of shopping for health care.
But only 22% of the health account plan members said their plans supply information about the cost of care provided by doctors, compared with 40% of the members of the traditional plans, researchers report.
Health account plan members said they were more likely to put off getting care because of cost concerns than members of traditional plans were, but the health account plan members reported in responses to other questions that they got about the same amount of most types of care as members of traditional plans received.
The health account members were about 20% more likely than traditional plan members to stay out of the emergency room, and they said they were much more likely to think twice before getting lab tests or imaging tests.
The health account plan members were more likely than traditional plan members to get Pap smears and cholesterol screening tests, but they were substantially less likely to get colon cancer screening tests, even though they tended to be about 10 years older than the members of the traditional plans.
Only 80% of the health account plan members reported having had a blood pressure check in the past year, even though 84% visited a doctor’s office at least once. About 85% of the traditional plan members said they had had blood pressure checks in the past year.
Demographic changes either in the survey participant pool or health account plan membership could be responsible for some of the differences between the 2005 and 2006 survey results.
The percentage of health account plan members surveyed who had at least a college degree fell to 56%, from 67% in 2005, and the percentage with annual household incomes over $100,000 fell to 11%, from 21%, according to methodology notes included with the 2005 and 2006 survey reports.
About 21% of the traditional plan members reported having annual household incomes over $100,000, but only 33% said they have a college degree.