As high-deductible health plans in conjunction with health savings accounts (HSAs) take their place in the healthcare industry, healthcare professionals, insurance organizations, and consumer advocacy groups debate the pros and cons of the controversial Consumer Driven Health Plans (CDHPs).  

Depending on who you talk to, CDHPs are either a panacea for the problem of rising health care costs and a successful example of consumer involvement, or a financial deterrent to consumers' seeking preventive and routine medical care.

In 2003, just as CDHPs were emerging, the AARP Public Policy Institute issued a paper, "Decision Making in Consumer-Directed Health Plans", that outlines the challenges faced by consumers in the decision making process regarding the high deductible plans.   In addition to the possible advantages of CDHPs, the paper asserted that there are serious challenges for enrollees, one of which is the complexity of information needed to understand the plans and make appropriate decisions.

On the other hand, this January American Health Insurance Plans (AHIP)   reported a survey of its member companies, which represent most of the companies offering CDHPs, stating that over 3 million consumers use CDHPs in conjunction with Health Savings Accounts (HSAs).    According to AHIP, that's triple the number of enrollees since March of 2005.  

The good news for hospitals is that about a third of new enrollees in CDHPs are previously uninsured.   According to a March 9 press release, AHIP states that 31percent of individuals who enrolled in CDHPs were previously uninsured, and 33 percent of small group policies were purchased by companies that have not offered health insurance in the past.

But how much do consumers know about this latest trend in healthcare coverage?   If they're aware of the CDHPs, are they likely to choose that type of plan?   For the first time in its 2005/06 edition, the NRC Healthcare Market Guide survey asked participants about consumer directed health plans.

Respondents were asked if their primary health insurance was a "high deductible policy" or "Consumer Directed Health Plan".   In the National market, of those who responded, 10.1% answered yes, 68.2% answered no, and 21.7% answered don't know. At the state level, participation in CDHPs ranged from 6.6% in Massachusetts to 17.3% in Mississippi .

Over twice as many people responded "don't know" than responded "yes" at the national level.   This suggests that the 2003 AARP conclusion regarding the complexity of information required to understand CDHPs still holds true.

In response to being asked if they were likely to consider this type of policy if it were offered to them, only 6.2% of respondents indicated that they were "likely" or "very likely" to consider this type of policy.

Sources

AHIP
http://www.ahip.org/

AARP
http://www.aarp.org/research/health/