A recent development is a signal NAIC has taken it regulatory reach to a new level.
In the face of another year of economic volatility and legislative and regulatory change, Cigna announced that its consumer- driven health plan (CDHP) participation grew by 26 percent during 2012, resulting in one-in-five Cigna customers now participating in a Health Savings Account (HSA) or Health Reimbursement Account (HRA).
"The growth of consumer-driven health plans continues because they help customers reduce their health risks and improve the quality and efficiency of their care, which result in lowering their total medical costs," said Cigna President and Chief Executive, David M. Cordani. "The evidence in our Seventh Annual Cigna Choice Fund Experience Study is clear, consistent and compelling: our CDHP customers are more engaged with their health and health spending, they spend less to receive the same levels of recommended care, and are more satisfied with their health care experience."
Released recently, the Seventh Annual Cigna Choice Fund Experience Study compares the actual claims experience of more than 2.5 million Cigna customers who are enrolled in either a CDHP, a traditional PPO or HMO health plan. The annual study provides empirical evidence that properly designed CDHP plans improve total medical cost without compromising care or shifting costs from the employer to employees.
According to the study, when compared to customers in traditional PPO and HMO plans, those in a CDHP:
-Lowered their health risks: Cigna CDHP customers lowered their risk of developing or worsening a chronic condition. According to the study, when employers fully transitioned to offering only a CDHP option, individuals improved their health risk profile by 12 percent in the first year compared to customers in a traditional plan.
-Reduced total medical costs: Cigna CDHP medical cost trend was 13 percent lower than traditional plans during the first year: costs were 20 percent lower for HSA customers and 11 percent lower for HRA participants. Cost reductions were achieved without employers shifting out-of-pocket health expenses to their employees. Notably 75 percent of HSA customers contribute more to their accounts than they spend.
-More engaged in health improvement: Cigna CDHP customers were twice as likely to complete a health risk assessment and CDHP customers with a chronic illness are up to 25 percent more likely to participate in a disease management program than those enrolled in a traditional plan.
-Were more likely to compare cost and quality: Cigna CDHP customers were 59 percent more likely to use the directory to access cost and procedure information to help them review potential medical costs.
-Were more savvy consumers of health care: Customers with Cigna Choice Fund plans and Cigna pharmacy benefits were more likely to choose generic medications compared to those in a traditional plan. In addition, CDHP customers used the emergency room at a six percent lower rate than individuals enrolled in HMO and PPO plans.
-Received higher levels of care: Cigna CDHP customers had consistent or higher compliance with over 300 evidenced-based medical best practices than their counterparts in traditional plans. Cigna CDHP customers also sought preventive care, such as annual office visits and mammograms, more frequently than customers enrolled in a traditional plan.
Cigna said that one company that is utilizing its Choice Fund consumer-driven health plans is JPMorgan Chase, a global financial management firm. According to JPMorgan Chase Healthcare & Insurance Plans Manager, Kathy Roehrig: "JPMorgan Chase opted for fully replacing our medical plan options with consumer-driven health options in order to encourage our employees and their families to focus more on the current status of their health, to improve or maintain that status (for those that were healthy) over the short and long term, and to become educated consumers of health care services by using providers/drugs that are considered quality and cost effective alternatives."
"While we just completed our first year under the new plan, we've seen many people taking steps to monitor and improve their health, including receiving age- and gender-appropriate preventive care screenings at rates above industry averages, increased visits to a primary care physician, good usage of Wellness Screenings where 14 percent of those screened learned about a health risk for the first time, and increased usage of generic medications," Roehrig said. "We feel providing appropriate access to quality health care providers, information regarding the quality and cost of those various providers, and appropriate health and condition management coaching programs are important components to our success. Incentives and communications are used to encourage our employees to better understand their options and make decisions that are right for them and their families."
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