Aetna: More Members Using Consumer-Directed Health Options

February 17, 2004 ( - Health care consumers are becoming more active in the day-to-day management of their insurance benefits, utilizing preventive-care options 16% more often, while the overall costs of their health care plans remained relatively flat.

Aetna found the nearly 14,000 members enrolled in the insurer’s consumer-directed option, Aetna HealthFund, experienced only a 1.5% rise in medical costs over the previous year, compared to double-digit increases for a similar population in more traditional health care offerings. To this, Aetna attributes the diligence of the active health care consumer in making the right decisions about the amount, and level, of coverage that is appropriate for them.

“Health care consumerism is about putting more of the decisions in the hands of the consumer, and providing them with useful tools and information that allow them to make decisions more comfortably,” said Aetna President Ronald Williams in a news release, “These early results indicate to us that consumers can and will responsibly manage their own discretionary health care spending, while continuing to seek the care that they need.”

Overall, Aetna found preventive care office visits increased by 30.1% – including increases in the number of routine physicals for both adults and children, as well as gynecological exams – compared to a 14% increase for a similar population. Consumerism increases were also noted in the 12.8% rise by m embers enrolled in an integrated pharmacy plan to use generic medications. Consequently, members experienced a 6.5% decrease in pharmacy costs driven by an 11% decline in overall prescriptions and a 12.8% increase in overall generic utilization.

With the increase in consumerism noted by Aetna, it comes as no surprise to see a rise noted by the insurer in more and more members utilizing Aetna Navigator, Aetna’s onlinesuite of consumer tools and information. Overall, members are logging on 11% more often. While on the site, members utilize DocFind, Aetna’s online physician directory, 13% more often and Aetna InteliHealth, Aetna’s consumer health information Web site, 48% more often.

Not only are Aetna’s consumer-directed members seeing reduced cost increases in their health plan, but they also have money left over. More than half of Aetna HealthFund members had fund dollars left to roll over into 2004 and on average, those members rolled over 31% of theirfund.

This study included employees from 19 employers, and compared nine months (January through September) 2003 claims and utilization data, to nine months of experience for the same group of members in 2002 (prior to their joining Aetna HealthFund).