Study Details Spending of Consumer-driven Health Plan Enrollees

WASHINGTON, D.C. — People with consumer-driven health plans (CDHPs) had lower total per-capita spending on healthcare, driven in part by using less healthcare overall, than people with traditional non-CDHP commercial health plans, finds a new study from the Health Care Cost Institute (HCCI).

At the same time, spending out of pocket by CDHP consumers was 1.5 times higher on average than non-CDHP consumers. For example, people enrolled in consumer-driven health plans paid an annual average $58 more out of pocket on visits to the doctor and $50 more on emergency room visits than their non-CDHP counterparts, while using roughly 8{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} fewer visits, respectively.

The study, “Consumer Driven Health Plans: A Cost and Utilization Analysis,” examines healthcare use and spending from 2010 to 2014 for people covered by employer-sponsored insurance and under 65 years of age who are enrolled in CDHPs. Enrollment in CDHPs has been steadily increasing within HCCI’s employee-sponsored insurance population; more than one-quarter had a CDHP in 2014, compared to just 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in 2010.

Overall, the study found that that fewer total dollars were spent on healthcare for people with CDHPs, in part because people with CDHPs tended to use fewer healthcare services. However, people with CDHPs had higher spending out of pocket on deductibles, co-pays, and co-insurance (excluding premiums). This higher out-of-pocket spending meant people enrolled in CDHPs were responsible for nearly one-quarter of their medical costs on average, compared to 14{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} for those enrolled in non-CDHPs.

“As the costs of healthcare increase, consumer-driven health plans try to balance lower premiums with higher deductibles and higher limits on out-of-pocket spending,” said HCCI Senior Researcher Amanda Frost. “As these types of plans grow in prevalence, it is important to look beyond premium dollars and also consider dollars spent directly on healthcare services.”