Consumer-Directed Health Plans: Are They Working As Intended?
Note: I was inspired to write this post because of an article I read in the current round of the Health Wonk Review. Check out the latest excellent edition here.
A couple of weeks ago, Jane Sarasohn-Kahn published a great analysis of some of the latest data from EBRI and the Commonwealth Fund focusing on the state of consumer-driven health plans (CDHPs). In sum, the data’s not good.
Before I get into a discussion of Sarasohn-Kahn’s analysis, it’s best to talk briefly about the war of words currently swirling around CDHPs. Last year, , Gred Scandlen published a report, “CDHPs – ‘Working As Intended,’” where he noted that many studies are flawed and obscure the true benefits of CDHPs. He argues that:
- Recent surveys find CDHPs have continued to grow rapidly
- High-deductible plans encourage people to take their care seriously, e.g., they are much more likely to go to their doctors to manage chronic conditions
- “CDHP members are [not] likely to forego care due to cost”
Now, with that in mind, let’s look at what EBRI and the Commonwealth Fund found. Most importantly, their study indicates that the healthy and wealthy are most likely to use CDHPs. Sarasohn-Kahn notes that this is not what CDHPs were designed to do. In fact, they have been touted as a means of getting more people into insurance plans. In addition, although more affluent individuals are using these plans, Sarasohn-Kahn notes that “members of CDHPs and HDHPs are more likely to delay going to a doctor, visit a specialist, or undergo medical tests than members of comprehensive plans.”
I’m not going to take a position on whether CDHPs are successful just yet. However, juxtaposing Scandlen’s analysis with EBRI’s research raises some interesting questions. Most importantly, which numbers are we to believe? Unfortuantely, there’s no good answer for this question.
