A new report from the Employee Benefit Research Institute (EBRI) suggests that not only are people who are enrolled in consumer-driven health plans more cost conscious, but they’re also more engaged with mobile health and digital health tools.
EBRI is a nonprofit, nonpartisan group that seeks to provide objective data about different employee benefit options. In December, the group conducted an online survey of 4,498 privately insured adults.
The survey found that about 10 percent of the population (about 11.6 million adults) is enrolled in a consumer driven health plan (CDHP), defined as an account-based health plan with either a health savings account or a health reimbursement arrangement. This is up from 7 percent in 2011 and 5 percent in 2010, so enrollment in these types of plans is on the rise, albeit slowly.
As Jane Sarasohn-Kahn writes over at Health Populi, the objective of these plans is to get health plan users to behave more like consumers by increasing their personal financial exposure to their health care costs. Once healthcare consumers start acting more like consumers, the theory goes, free market forces will start to drive down healthcare costs.
Much of EBRI’s data suggests that where CDHPs are being adopted, they are having that predicted effect, at least to some degree. For instance, those on CDHPs were more likely than those on traditional health care plans to check whether their plan covered a treatment, to ask for a generic drug rather than a brand name, or to check the price of a service before getting it. Generally these differed by 7 to 10 percentage points from CDHP users to traditional plan users. Twenty-six percent of CDHP users had developed a budget to manage health care expenses, compared to 16 percent of traditional plan users and 23 percent had used an online cost-tracking tool, compared with 11 percent of traditional plan users.
In addition, EBRI asked respondents about their use of health apps and whether use of health information technology affected their choice of physician. Out of those who are already using a smartphone or tablet, the report indicates that CDHP users led the pack in using health apps for nutrition information (32 percent versus 27 percent), general health information (29 percent versus 25 percent), weight management or diets (27 percent versus 23 percent), and exercise programs (25 percent versus 23 percent). However, with a margin of error plus or minus 2.2 percent, there may be less of a difference between the two groups. The one area where adoption of apps showed a distinct difference was using apps to research medical claims history, something 11 percent of CDHP users did compared with only 6 percent of traditional plan users.
When asked whether they would switch to a doctor who used more health information technology (having a secure website for patients to access records, using a smartphone or tablet, and emailing with patients) CDHP enrollees were more likely than those on traditional plans to say they would switch doctors for that reason, with or without a cost-sharing incentive.
EBRI acknowledged that the differences between the groups could be as much about the character of people who currently choose CDHPs as about the effect the CDHP itself has on decisions. The CDHP group was healthier overall, less likely to smoke, and more likely to exercise.