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Dissatisfaction Widespread Among Health Account Plan Users

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Users of health account plans appear to be less satisfied than users of traditional managed care plans.

Consultants at Towers Perrin Inc., Stamford, Conn., have published data supporting that conclusion in a report that compares members of traditional managed care plans with members of plans that offer access to health savings accounts or health reimbursement arrangements.

Only 50% of the account plan members said they are satisfied or very satisfied with the ability of their current plans to protect them against the risk of major health care costs, compared with 65% who are not members of account plans.

Account plan members said they are even less satisfied with other aspects of their plans.

In theory, HSAs and HRAs are supposed to help holders save for retirement, but only 22% of the account plan members said they are satisfied or very satisfied with the ability of the plans to help them prepare for retirement health care expenses, compared with 30% of the traditional plan members.

Only 16% of the health account holders said they are using the accounts to save for retirement health care expenses.

About 71% of the account plan members who believe their plans protect them against major health care risks said their plans are easy to understand and use, but only 16% of the dissatisfied account plan members said their plans are plans are easy to understand and use.

The survey results imply that satisfied health account plan members may be more likely to try to take an active role in their care than the dissatisfied members are.

Only 45% of the dissatisfied members said they explore risks and costs before following doctors’ recommendations, but about 64% of the satisfied members said they do so.

Dave Guilmette, managing director of Towers Perrin’s health and welfare practice, says the results show employers and health account plan companies have to do more to reach out to employees if they want the programs to expand.

Account plan “members often have access to the same provider networks as those in the traditional health plans, with the added benefits of being able to save for future medical expenses, but the overall perception on the part of employees is that [the plans] are cheaper and inferior plans,” Guilmette says.

“The employees’ views suggest a lack of trust in employer practices and motives surrounding the introduction of [account-based health plan] options,” he adds. “Any consumer product that scored as low as ABHPs do in terms of customer satisfaction and understanding would be significantly retooled or pulled from the shelves.”

Employers that see account-based plans as an important tool for controlling health care costs need to act now to explain why the new plans are good for the employees as well as for the employers, Guilmette says.

Too often, employers try to avoid rocking the boat by taking a “minimalist approach” to explaining the new plans, he adds.

“The unintended result is that employees feel even more uncomfortable and confused by the plans,” Guilmette warns.

The Towers Perrin survey report is the second to address account plan member satisfaction levels in less than 6 months.

In December 2006, researchers at the Employee Benefit Research Institute, Washington, and the Commonwealth Fund, New York, who have traditionally viewed the account plan movement with skepticism, reported that only 45% of the account plan members in their participant pool said their plans are “easy to understand,” down from 54% in 2005.

Although advocates of account plan programs say they can turn consumers into better health care shoppers, only 22% of the EBRI-Commonwealth Fund account plan members said their plans supply information about the cost of physician care, while 40% of the managed care plan members said their plans provide physician care cost data.

The EBRI-Commonwealth Fund researchers found signs of a possible change in account plan member demographics. The percentage of account plan members surveyed who had at least a college degree fell to 56% in 2006, from 67%, and the percentage with annual household incomes over $100,000 fell to 11%, from 21%.


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