CDHPs Lead To Fewer Physician Visits

By Cyril Tuohy

InsuranceNewsNet

Consumer-directed health plans (DCHPs), which make employees pay a higher percentage of their health expenses, have led to fewer physician visits and lower uses of prescription drugs, according to a comparative study.

The Employee Benefit Research Institute (EBRI) study compared two large companies, one offering employees consumer-directed health options only, and another with none. The study found that after four years there were 0.26 fewer doctor office visits per enrollee per year, and 0.85 fewer prescriptions filled per enrollee per year.

In other words, an employee or their dependent who, on average, visited the doctor’s office four times a year under a traditional health plan, would visit the doctor three times a year under a consumer-directed plan.

There were, however, slightly more emergency room visits – 0.018 – for employees covered by the consumer-directed model. The likelihood of receiving recommended cancer screenings was also lower under the consumer-directed model, the EBRI study found.

Employers adopted consumer-directed health plan models in 2001 to make employees more cognizant of health care expenses, which have consistently outpaced inflation.

Initially, employers instituted a reimbursement arrangement for employees, but later adopted health savings accounts where employees put money aside to pay for health visits. The past several years have seen employers move to higher deductibles before insurance companies reimbursed the claim.

EBRI called the findings “statistically significant.” The goal of the study was to understand utilization and the impact of full-replacement of consumer-directed plans on health services use as more employers appear to be adopting that strategy as a way to limit their exposures to health care cost increases, EBRI also said.

“The availability of CDHP’s both as a choice and on a full-replacement basis is expected to continue to increase under the Affordable Care Act,” Paul Fronstin, director of EBRI’s Health Research and Education Program and co-author of the report, said in a statement.

While employers have gradually adopted consumer-directed models, surveys indicate that employees are not as fond of them. Employees complain that consumer-directed models are difficult to understand and require them make decisions about health insurance that they don’t necessarily feel comfortable with.

A study of the corresponding dollar savings of the lower usage is expected later this year, Fronstin also said.

Cyril Tuohy is a writer based in Pennsylvania. He has covered the financial services industry for more than 15 years. He can be reached at [email protected].

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Cyril Tuohy is a writer based in Pennsylvania. He has covered the financial services industry for more than 15 years. He can be reached at [email protected].