ANN ARBOR, Mich.--(BUSINESS WIRE)--Consumer-directed health plans (CDHPs) save money and the cost reductions stem primarily from lower utilization of healthcare services, according to a new study conducted by Truven Health Analytics™, a leading provider of healthcare data and analytics solutions and services. By comparing insurance claims data for CDHP members versus a matched cohort of non-CDHP health plan members over three years using the Truven Health MarketScan Commercial Claims Database, researchers were able to track detailed trends in healthcare costs and utilization patterns in the CDHP population.
The analysis found that CDHP members incurred healthcare costs that were between $457 and $532 per member per year lower than privately-insured individuals with traditional (non-CDHP) health plans. The lower cost was observed across all service settings – inpatient, outpatient, and prescription drug – with the highest difference seen in the prescription drug category.
The bulk of the cost reduction was driven by lower utilization among CDHP members. The analysis found that lower utilization rates drove between 63 and 75 percent of the cost differential between CDHPs and non-CDHPs. Showing notably lower than expected utilization rates among CDHP enrollees were radiology services, professional visits, lab services, non-maternity admissions, and prescription drugs.
The study also found that CDHP members were less likely to receive any medical care for existing chronic conditions than their non-CDHP counterparts. This finding was based on a review of eight common conditions – asthma, congestive heart failure, coronary artery disease, depression, diabetes, hypertension, low back disorders, and osteoarthritis.
“With employers under immense pressure to reduce healthcare costs, it is critical that they understand the impact of plan design on member behavior and incorporate strategies to ensure they are giving their employees access to the highest quality care,” said Barbara Graovac, senior vice president at Truven Health Analytics. “CDHPs can be a great way to save money, but health plans and employers must work to engage consumers to play an active role in their health care — making use of preventive care measures and appropriate care strategies for chronic conditions ― or the plans and employers could end up facing higher costs in the end.”
CDHPs generally feature a high-deductible medical plan with full preventive care coverage. With the higher deductible comes a lower premium cost; many companies offer a healthcare savings account (HSA) to which CDHP members may choose to contribute pre-tax dollars including their premium savings.
Additional report findings include:
- CDHP Membership Grows Four-Fold: The number of organizations offering a CDHP doubled and the number of members enrolled in a CDHP quadrupled between 2007 and 2013.
- Generic Drug Utilization Higher Among CDHP Members: Use of generic medication was higher for CDHP members.
- Recommended Care for Diabetes and Coronary Artery Disease Lower Than Expected Among CDHP Population: The percent of CDHP members receiving recommend tests and prescription drugs for these chronic conditions was generally lower than expected.
This study was conducted based on data from the MarketScan Commercial Claims Database, which contains information on enrollment, outpatient services, prescription drug use, and hospital admissions from more than 120 million insured individuals. A cohort group of approximately 183,000 continuously enrolled members was followed from 2009 to 2012. These group members were enrolled in a non-CDHP in 2009 — and then continuously enrolled in a CDHP in 2010, 2011, and 2012. To compare results for non-CDHP members, the healthcare experience of each member of the CDHP cohort was compared with that of a carefully matched enrollee from a company that did not offer a CDHP during the same timeframe.
To access a copy of the full study, The Impact of Consumer-Directed Health Plans on Costs, Utilization, and Care, please click here.
About Truven Health Analytics
Truven Health Analytics delivers the answers that clients need to improve healthcare quality and access while reducing costs. We provide market-leading performance improvement solutions built on data integrity, advanced analytics, and domain expertise. For more than 30 years, our insights and solutions have been providing hospitals and clinicians, employers and health plans, state and federal government agencies, life sciences companies, and policymakers the facts they need to make confident decisions that directly affect the health and well-being of people and organizations in the U.S. and around the world.
Truven Health Analytics owns some of the most trusted brands in healthcare, such as MarketScan, 100 Top Hospitals, Advantage Suite, Micromedex, Simpler, ActionOI, Heartbeat Experts and JWA. Truven Health has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit http://truvenhealth.com
