Health Insurance Daily

CDHP Users Get More Preventive, Less Acute Care

Consumer-driven health plan members seek more preventive care and less acute care than patients enrolled in preferred provider organizations, a UnitedHealth Group study reveals.

The study compared cost and utilization trends among 40,000 people in high-deductible plans connected to health reimbursement accounts to data from 15,000 people in PPOs between 2003 and 2005. About 5% more CDHP members sought preventive care, compared to PPO enrollees, during each of the three years.

Hospital admissions and emergency room visits fell among CDHP users annually, but increased among PPO users. Chronically ill CDHP enrollees reduced their use of acute care, but continued to visit their primary care physician at the same rate as their peers in traditional plans. Cost per member fell 3% to 5% among CDHP users, but rose 8% to 10% among PPO participants, compared to the 2003 baseline.

The results are "not yet conclusive," admits Mike Tarino, CEO of Definity Health, a UnitedHealth Group company, but they support anecdotal reports that CDHPs can lower costs and boost health care outcomes.

CDHPs can reduce cost-sharing for patients who spend the least and the most on health care, but increase cost-sharing for those who fall in the midrange, according to a new study published in Health Affairs. With HSA contributions shielded from federal and state income taxes, very healthy people would have lower cost-sharing under a CDHP than under a comprehensive plan. Those with medical expenses between $700 and $2,500 per year would see an increase in cost-sharing. PricewaterhouseCoopers healthcare expert Mike Thompson says HSAs have the most influence on low-cost, high-frequency items like office visits and prescriptions.

This article was published by BenefitNews, July 13, 2006

posted by Mike @ 8:07 AM