Members of health plans that incorporate health savings accounts or health reimbursement arrangements seem to be more likely to get preventive care than members of conventional plans are.
Paul Fronstin, a researcher at the Employee Benefit Research Institute, Washington, and Sara Collins, a researcher at the Commonwealth Fund, New York, organizations that have been critical of health account plans, have reported those findings in an analysis of results from a Web-based, 2007 survey of 4,217 privately insured adults ages 21 to 64.
The researchers conducted similar surveys in 2005 and 2006.
Only about 2% of survey participants said they were enrolled in health account plans in 2007, up from about 1% in 2005, and about 31% of the 2007 health account plan members had annual household incomes of at least $100,000, up from 22% in 2005, Fronstin and Collins write in their analysis.
About 47% of the health account plan members who participated said they are extremely or very satisfied with their plans. That figure has increased from 37% in 2006 but is much lower than the 64% satisfaction rate for conventional plans.
Health account plan advocates have described the plans as a vehicle for holding down cost increases and expanding access to coverage.
“Over the 3 years of the survey, more people in consumer-driven plans are earning higher incomes, tend to be healthier and are no more likely to have been uninsured prior to enrolling than people in traditional health plans,” Collins says in a statement about the results. “These plans are not yet solving the problems they set out to address.”
But the survey results suggest that efforts by high-deductible health account plans to offer wellness benefits on a low-deductible or no-deductible basis are paying off.
Health account plan members appear to be getting about as much preventive care as members of conventional health plans, and they report that they are using prescription drugs at about the same rate as conventional plan members.
Both for all health account members and health account members with annual household incomes under $50,000, the percentage who reported having a blood pressure check in the past year was lower than for comparable conventional plan members.
But health account plan members were more likely to have had the other screening tests mentioned in the survey.
About 82% of all women in health account plans said they had undergone Pap smear tests within the past 3 years, compared with just 77% of the conventional plan members.
For survey participants with annual household incomes under $50,000, the percentage getting the recommended Pap smear tests was 80% for health account plan members and 71% for conventional plan members. The percentage getting the recommended cholesterol tests was 62% for the health account plan members and 52% for the conventional plan members.
The percentage of all health account plan members who said they had not been in a doctor’s office in the previous year held steady at 16%, while the percentage of conventional plan members who had not visited a doctor’s office increased to 13%, from 10%.
The percentage of health account plan members who said they had avoided filling prescriptions or skipped doses because of cost concerns fell to 24%, from 31% in 2006, while the percentage increased to 23%, from 22%, for members of conventional plans.