Consumer Driven Health Care Plans Can Help Consumers Reduce Health Care Spending and Make Positive Behavior Changes
Consumers enrolled in Consumer Driven Health Plans (CDHPs) are more likely to make sustainable, positive behavior change leading to significant health plan spend reductions year over year, according to data studied by Health Care Service Corporation (HCSC), operator of the Blue Cross and Blue Shield Plans in Illinois, Texas, Oklahoma and New Mexico. Members who migrated to CDHP plans – those that have a higher deductible, prompting consumers to be more directly involved with the selection and usage of health care services – reduced their health care spending significantly.
This study is unique because of its focus on tracking individual members who migrated from traditional health plan coverage to CDHP coverage in order to analyze their health care behavior and their health care spending habits both before and after the switch. The data also showed that changes in behavior, including increases in preventive care and use of generic prescriptions, helped contribute to a reduction in health care spending for both employers and members.
The CDHP program, BlueEdge, is offered through the four Blue Cross and Blue Shield Plans, and includes Health Savings Account (HSA) and Health Reimbursement Account (HRA) options. BlueEdge enrollment surpassed 1.5 million members earlier this year, after experiencing double-digit percentage increases for six straight years.
Key results from the study indicate that, following migration from a traditional non-CDHP plan to a CDHP, on average, the CDHP members studied:
were four percent more likely to take advantage of preventive services.
reduced health care utilization by an aggregate of more than 12 percent.
were 10 percent more likely to fill their prescriptions with generics.
spent 24 percent less on inpatient hospital services and eight percent less on outpatient services.
had a 12 percent decrease in emergency room visits.
reduced combined medical and pharmacy spend by an aggregate of 11 percent
In addition, data showed that employers who offered only a CDHP saw even greater spend reductions – up to an aggregate of 14.4 percent over the three years following migration from a traditional plan to a CDHP.
"Our BlueEdge CDHP program gives consumers the flexibility and tools to help make positive decisions to reduce their healthcare spend, coupled with broad access to care, award-winning service, comprehensive incentives, wellness and care management programs, and a personalized, engaging health care experience," said Thomas Meier, Vice President, product development, HCSC. "Our experience finds that CDHP members tend to be more engaged and informed in making better health care decisions."
This is the second year that HCSC has done this analysis, this year studying more than five years of data for more than 265,000 members (with pharmacy data available on 121,000 of those members). HCSC continues to invest in more consumer focused approaches, adding more robust incentives and value-based insurance design products in 2013 to complement both traditional and CDHP plans.
"Our findings are significant because they indicate both real and potential health care spend reductions. Rather than comparing the utilization of different groups of consumers, we have focused on the utilization changes of members who migrated from traditional plans to CDHP. The fact that we are comparing the same members in both plans allows us to minimize inherent risk differentials," said Guy McGinnis, Vice President, client analytics, HCSC.