EBRI Research on Effectiveness of Consumer-Directed Health Plans

Consumer-directed health plans (CDHP), designed to make employees make more cost-and health-conscious decisions, have been shown to reduce the long-term use of outpatient physician visits and prescription drugs, according to new research by the nonpartisan Employee Benefit Research Institute (EBRI) authored by a team led by Paul Fronstin, Ph.D. (past speaker at the March 2013 NHLC meeting in Dallas, TX).

The research used data from two large employers—one that adopted a health savings account (HSA) plan for all of its employees in 2007, and another with no CDHP—and found that after four years under the HSA plan, there were 0.26 fewer physician office visits per enrollee per year and 0.85 fewer prescriptions filled, although there were 0.018 more emergency department visits (all of which are considered statistically significant). Additionally, the likelihood of receiving recommended cancer screenings was lower under the HSA plan after one year and, even after recovering somewhat in later years, still lower than baseline at the study’s conclusion.

The theory behind CDHPs is that as participants are exposed to a high deductible before insurance benefits are triggered, enrollees will be induced to make better health care use decisions, such as not going to an emergency department when a visit to a physician would suffice. Although usually offered alongside more traditional health plan designs, CDHPs are slowly increasing as employers’ only health insurance offering.

The research findings are published in the June 2013 issue of Health Affairs, and can be accessed online here. This work was conducted through the EBRI Center for Research on Health Benefits Innovation (EBRI CRHBI). The following organizations provided the funding for EBRI CRHBI: American Express, Blue Cross Blue Shield Association, Boeing, CVS Caremark, General Mills, Healthways, IBM, John Deere & Co., JP Morgan Chase, Mercer, and Pfizer.