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September 10, 2004
1:30-3:30 p.m. Eastern Daylight Time
Research
Results and Policy Context
Research Results
Meredith
Rosenthal, Ph.D. and colleagues at the Harvard School of Public
Health examined the prevalence and the typical benefit structure
of consumer-driven health plans (CDHPs) in the market. In a series
of 13 case studies, Dr. Rosenthal investigated the primary motivation
for, design and early experience of early adopters of CDHPs. Early
adopters reported favorable cost savings for CDHPs and there is
no evidence of dramatic reductions in service use or increases in
adverse health consequences. These reports are consistent with findings
that CDHPs do not require substantial new cost sharing, as compared
with alternative plans offered by the same employers.
Stephen
T. Parente, Ph.D. and colleagues’ work at the University of
Minnesota explored the medical service use and expenditures of employees
enrolled in a consumer-driven health plan. Findings from his study
highlighted the experience of early adopters from the employer and
employee perspective. Key findings are that physician visits and
pharmaceutical use and costs were lower in the CDHP group, as compared
with other groups. Parente's most recent findings have focused on
pharmacy costs. Early evidence suggests that overall costs in consumer-driven
plans are less than in a PPO, but greater than in an HMO. Findings
also suggest that brand name drug use is higher in CDHPs, but overall
cost is lower. Study findings may shed light on the likely impact
of 3-tier drug formularies.
Judith
Hibbard, Dr.P.H. and colleagues at the University of Oregon explored
the validity of assumptions about consumer behavior underlying consumer-driven
health plans. The key assumption she examined is whether consumers
will take charge of their health and health care and make cost-effective
choices if they are given financial incentives and information to
support their choices. Working with Definity Health Plan and the
Whirlpool company, Hibbard compared the knowledge, use of information,
satisfaction with care, cost-effective utilization, and cost of
care for groups enrolled and not enrolled in a consumer-driven plan.
She discussed early survey data from her project.
Policy
Context
These
studies provide the latest evidence on CDHPs in today's marketplace
and address issues for public and private policy. What is the cost
sharing experience of CDHP enrollees and how does that experience
inform the current debates surrounding health savings accounts?
To what extent will evidence exploring the relationship between
CDHPs and pharmacy costs shape drug formularies going forward? What
information are consumers really likely to use in making their decisions
about care? What do employers need to consider as they explore new
models? As purchasers and regulators, what do states need to know
as they play an active role in their markets?
The
moderated policy discussion began with comments by Paul Fronstin,
of the Employee Benefit Research Institute, and Scott Leitz, of
the Minnesota Department of Health. Fronstin and Leitz reacted to
the research findings, placing them in a “real world”
context. They also discussed the implications of the research for
the private market and state and federal policy. Finally, Fronstin
and Leitz explored what this research means in the context of increased
availability of, and interest in, account based consumer-driven
health plans. Following the moderated discussion, participants in
the Cyber Seminar were able to ask questions and make comments online
through the virtual chat room.
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