CDHP Participants More Likely Healthier and Earn More

November 18, 2008 ( - Enrollment in consumer-directed or high-deductible health plans eligible for a tax-preferred savings account increased to 9.8 million this year, but participants are more likely to have higher incomes and be in better health than those with traditional health coverage, according to a survey by the nonpartisan Employee Benefit Research Institute (EBRI).

According to an EBRI news release, in 2008, 40% of those in consumer-directed plans were in households with incomes of $100,000 or more, while just 14% of adults with consumer-directed plans lived in households with incomes under $50,000. In addition, the survey found individuals in consumer-directed health plans are significantly less likely to have a health problem than were adults in high-deductible or traditional plans, are significantly less likely to smoke than were adults in traditional plans, and are significantly more likely to exercise.

These findings are similar to those of the EBRI/Commonwealth Fund Consumerism in Health Care Survey from March of this year (See CDHPs not Living up to Hype ) which indicated CDHPs or HDHPs combined with a tax-advantaged savings or reimbursement account are not living up to claims they would decrease the number of uninsured, encourage cost-consciousness among consumers, and increase the amount of information on the cost and quality of providers.

In 2008, 3% of the population was enrolled in a CDHP, up from 2% in 2007. Enrollment in high-deductible health plans remained at 11%. Among the 13.4 million individuals with a high-deductible plan, 42% (or 5.6 million) reported that they were eligible for a health savings account but did not have such an account.

EBRI said it found individuals in consumer-directed and high-deductible plans were more likely to consider costs in their decisions about health care than those in traditional plans. Those in consumer-directed and high- deductible plans also were more likely than those in traditional plans to ask their doctor to recommend a less costly prescription drug.

According to the news release, the gap in satisfaction between those in traditional plans and those with consumer-directed plans disappeared because satisfaction increased significantly among those with consumer-directed plans.

The 2008 EBRI Consumer Engagement in Health Care Survey involved a 16-minute online survey of 4,532 privately insured adults ages 21 – 64.

Full results are published in the November EBRI notes at .