Consumer-driven health plans were designed to help slow rising health care
spending by corporations. But the schemes may fail if employers don’t provide
employees with proper education, finds a study released Tuesday, January 15, by
the not-for-profit Employee Benefit Research Institute.
“Since the vast majority of Americans who have health coverage obtain it
through their (or a family member’s) employer, and with health benefits on track
to become the single-largest expense of any employee benefit, the issue of
education is important, both to the sponsors and the beneficiaries of health
insurance coverage,” study authors Lois Vitt and Ray Werntz say in the
report.
Consumer-driven plans, which EBRI notes have several million participants,
typically are more expensive and place more responsibility on the user. Such
plans combine a tax-preferred account (a health savings account or health
reimbursement account) with a high deductible, and users are expected to pay
health costs either out of pocket or from one of their two accounts.
Advocates of such plans say that because employees shoulder the bill, they
are motivated to keep health care costs low.
But the study finds that there is no consensus among policymakers that this
will happen. In fact, the plans rely on employees making informed decisions
about their health care choices. Lacking that knowledge, consumer-driven health
care plans may fall flat.
Employers have been down this path before. The perceived ineffectiveness of
employee education for 401(k) plans resulted in legislation to add “defaults” to
these plans so that they no longer relied upon positive employee action. In the
health arena, the report states, the default approach is exactly what the
consumer-driven health model seeks to move away from.
The upshot? “Should health education initiatives prove ineffective, the
consumer-driven health movement could well be doomed, especially if it relies
upon fully educated health consumers taking self-initiated actions,” Vitt and
Werntz say.
Filed by Megan Johnston of Financial Week, a sister publication of Workforce
Management. To comment, e-mail editors@workforce.com.