Journal of Consumer Policy

, Volume 29, Issue 3, pp 247–262 | Cite as

Which consumers are ready for consumer-directed health plans?

  • Jessica Greene
  • Judith H. Hibbard
  • Anna Dixon
  • Martin Tusler
Original Paper

Abstract

Consumer Directed Health Plans (CDHPs) are new and increasingly popular insurance products in the United States that aim to increase consumer involvement in health care decision-making. Using quantitative and qualitative methods, we examine characteristics of employees in a large firm that voluntarily enroll in CDHPs. We find salaried and hourly high deductible CDHP enrollees to be substantially healthier and have higher educational attainment than Preferred Provider Organizations (PPO) enrollees. There was less favorable selection into a more popular, lower deductible CDHP.

Keywords

Consumer-directed health plan Consumer-driven health plan High deductible health plan Health Reimbursement Accounts Health Savings Accounts Health insurance 

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Notes

Acknowledgements

The authors wish to acknowledge the CDHP provider and the participating employer in the study for their openness and commitment to research on CDHPs. We also would like to thank “The Changes in Health Care Financing and Organization” (HCFO) initiative, a program of The Robert Wood Johnson Foundation, for providing support for this research.

References

  1. Agrawal, V., Ehrbeck, T., O’Neill Packard, K., & Mango, P. (2005). Consumer-directed health plan report -early evidence is promising. Pittsburgh: McKinsey & Company.Google Scholar
  2. Bureau of the Census (2000). Census 2000 Summary File 3 (SF3). Retrieved October 5, 2000, from http://www.census.gov/Press-Release/www/2002/sumfile3.html.Google Scholar
  3. Bush, G. (2006). Fact sheet: Health savings accounts: Myth vs. fact. Washington, DC: The White House. Retrieved April 5, 2006, from http://www.whitehouse.gov/news/releases/2006/04/20060405-3.html.Google Scholar
  4. Christianson, J. B., Parente, S. T., & Feldman, R. (2004). Consumer experiences in a consumer-driven health plan. Health Services Research, 39, 1123–1140.CrossRefGoogle Scholar
  5. Cross, M. (2005). Turning the corner: Momentum shifts toward consumer-directed plans [Electronic version]. Managed Care, 14(7), 28–36.Google Scholar
  6. Davis, K. (2004). Consumer-directed health care: Will it improve health system performance? Health Services Research, 39, 1219–1234.CrossRefGoogle Scholar
  7. Davis, K., Doty, M., & Ho, A. (2005). How high is too high? Implications of high-deductible health plans. New York, NY: The Commonwealth Fund.Google Scholar
  8. Fowles, J. B., Kind, E. A., Braun, B. L., & Bertko, J. (2004). Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment. Health Services Research, 39, 1141–1158.CrossRefGoogle Scholar
  9. Frates, J., & Severoni, E. (2005). Consumer-directed health plans: Enrollee views, early employer experience [Electronic version]. Managed Care, 14(6), 58–65.Google Scholar
  10. Fronstin, P., & Collins, S. (2005). Early experience with high-deductible and consumer-driven health plans. Findings from the EBRI/Commonwealth Fund consumerism in health care survey, Issue Brief 288. New York, NY: EBRI.Google Scholar
  11. Herzlinger, R. (2002). Let’s put consumers in charge of health care. Harvard Business Review, July, pp. 44–55.Google Scholar
  12. Herzlinger, R., & Nerney, T. (2005). Medicine for Medicaid. Wall Street Journal, August 2, p. A. 10.Google Scholar
  13. Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40, 1918–1930.CrossRefGoogle Scholar
  14. Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004). Development of the patient activation measure (PAM): Conceptualizing and measuring activation in patients and consumers. Health Services Research, 39, 1005–1026.CrossRefGoogle Scholar
  15. Lo Sasso, A. T., Rice, T., Gabel, J. R., & Whitmore, H. (2004). Tales from the new frontier: Pioneers’ experiences with consumer-driven health care. Health Services Research, 39, 1071–1090.CrossRefGoogle Scholar
  16. Mcneill, D. (2004). Do consumer-directed health benefits favor the young and healthy? Health Affairs, 23(1), 186–193.CrossRefGoogle Scholar
  17. Miles, M., & Huberman, A. M. (1994). Qualitative data analysis. London: Sage Publishers.Google Scholar
  18. Newhouse J. P., & The Insurance Experiment Group (1996). Free for all? Lessons from the RAND health insurance experiment. Cambridge, MA: Harvard University Press.Google Scholar
  19. Parente, S. T., Feldman, R., & Christianson, J. B. (2004). Employee choice of consumer-driven health insurance in a multiplan, multiproduct setting. Health Services Research, 39, 1091–1112.CrossRefGoogle Scholar
  20. Raniszewski Herrera, C. (2006). Pressure for market-based Medicaid reform rises. Budget and Tax News, Article 19069. Retrieved 19 June, 2006, from http://www.heartland.org/Article.cfm?artId=19069.Google Scholar
  21. Robinson, J. C. (2004). Reinvention of health insurance in the consumer era. Journal of the American Medical Association, 291, 1880–1886.CrossRefGoogle Scholar
  22. Robinson, J. C. (2005). Health savings accounts—the ownership society in health care. The New England Journal of Medicine, 353, 1199–1202.CrossRefGoogle Scholar
  23. Scandlen, G. (2004). Commentary—how consumer-driven health care evolves in a dynamic market. Health Services Research, 39, 1113–1118.CrossRefGoogle Scholar
  24. Shearer, G. (2004). Commentary—defined contribution health plans: Attracting the healthy and well-off. Health Services Research, 39, 1159–1166.CrossRefGoogle Scholar
  25. Tollen, L. A., Ross, M. N., & Poor, S. (2004). Risk segmentation related to the offering of a consumer-directed health plan: A case study of Humana inc. Health Services Research, 39, 1167–1188.CrossRefGoogle Scholar
  26. United States Department of Health and Human Services (2005). Summary health statistics for U.S. adults: National Health Interview Survey, 2003. DHHS Publication No. 2005–1553. Hyattsville, MD: Health and Human Services Department, Centers for Disease Control and Prevention, National Center for Health Statistics.Google Scholar
  27. United States Government Accountability Office (2006a). Consumer-directed health plans: Small but growing enrollment fueled by rising cost of health care coverage [Electronic version]. Report no. GAO-06–514. Washington, DC: US Government Accountability Office. (April 28, 2006).Google Scholar
  28. United States Government Accountability Office (2006b). Federal Employees Health Benefits Program: First year experience with high deductible health plans and health savings accounts [Electronic version]. Report no. GAO-06-271. Washington, DC : US Government Accountability Office. (January 31, 2006).Google Scholar
  29. Uyoo, H., & Chovan, T. (2005). Number of HSA plans exceeded 1 million in March 2005. America’s health insurance plans. Washington, DC: Center for Policy and Research. Retrieved June 10, 2006, from http://www.healthdecisions.org/HSA/.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Jessica Greene
    • 1
  • Judith H. Hibbard
    • 1
  • Anna Dixon
    • 1
  • Martin Tusler
    • 1
  1. 1.Department of Planning, Public Policy & ManagementUniversity of OregonEugeneUSA

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