Consumer-driven health plan members are richer, healthier, educated, but not younger

By Jonah Comstock
12:05 pm
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Mobile Phone UsersThe Employee Benefit Research Institute (EBRI) released population data from eight years of surveying consumer-driven health plan (CDHP) customers. The newly released data shows some unexpected findings about the population of CDHP users: namely that in most years, CDHP enrollees tended to skew older than traditional plan enrollees. That might come as a surprise, since MobiHealthNews reported in January on an EBRI report stating that CDHP users were also about 5 percent more likely to use a health app than those not enrolled.

"It is often assumed that CDHP enrollees are more likely than those with traditional coverage to be young, because they use less health care, on average," EBRI wrote in their notes. "However, that is generally not what has been found in these surveys. In most years, CDHP enrollees were less likely than those with traditional coverage to be between the ages of 21 and 34. In 2006, 2010, and 2011, the CDHP population was more likely than the population with traditional coverage to be ages 35–44. No statistically significant differences between the two groups were found in the percentage between the ages of 45–54, and only in 2009 was the population with traditional coverage composed of a larger share of 55−64-year-olds than the CDHP population."

Another surprising data point from the 2012 data, given the older-than-expected CDHP population, is their enthusiasm about doctors using health IT. 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.

The other significant differences the 8-year analysis found were that the CDHP population was generally higher-income, better educated and healthier than the traditional population. CDHP households were more likely than traditional plan households to make $150,000 a year or more in every year of data except 2009 and 2010. In nearly all years, CDHP customers were twice as likely as non-CDHP customers to have a collegiate or post-graduate education.

As for health, EBRI tracked a number of factors: obesity, smoking, exercise, self-reported health status, and presence or absence of a chronic health condition. CDHRP enrollees were more likely to report excellent or very good health and less likely to have a chronic condition than traditional health plan users.

"CDHP enrollees have consistently reported better health status than traditional-plan enrollees, exhibiting better health behavior than traditional-plan enrollees with respect to smoking and (except for 2010 and 2011), exercise, and sometimes obesity rates," they wrote. "HDHP [High-deductible health plan] enrollees have also been consistently less likely than those with traditional coverage to report that they smoke, but no recent differences were found in exercise rates, and differences have never been found in rates of obesity."

The study also looked at race and gender, but the findings there were less compelling. Race breakdown wasn't significantly different for CDHP and traditional plan users. Gender was different, but somewhat confusingly: traditional plan users consistently broke down about 50/50 on gender lines, but for the CDHP group more men than women used the plans in 2007 and 2008, and more women than men used CDHPs from 2010 to 2012.

CDHP enrollees have consistently reported better health status than traditional-plan enrollees, exhibiting better health
behavior than traditional-plan enrollees with respect to smoking and (except for 2010 and 2011), exercise, and
sometimes obesity rates. HDHP enrollees have also been consistently less likely than those with traditional coverage bri.org Notes • April 2013 • Vol. 34, No. 4 8
to report that they smoke, but no recent differences were found in exercise rates, and differences have never been
found in rates of obesity.
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