CDHPs Grew in 2012

June 19, 2013 ( – Consumer-directed health plans (CDHPs) were the only type of health insurance that grew in 2012, a new analysis finds.

The American Association of Preferred Provider Organizations (AAPPO) conducted an analysis of the “Mercer National Survey of Employer-Sponsored Health Plans,” which examined CDHP enrollment, and of U.S. Census Bureau estimates of how many people have private health insurance. AAPPO found that 39 million were enrolled in CDHPs in 2012, compared to 33 million in 2011, which was an increase of 19%.

The AAPPO analysis found that among large employers—those with 500 or more employees—offerings of CDHPs increased from 32% in 2011 to 36% in 2012. Smaller employers—those with 10 to 499 employees—were found to be less likely to offer a CDHP (22%), but are more likely to offer a CDHP as the only medical plan option. CDHPs were found to be offered by 59% of the country’s largest employers—those with 20,000 or more employees.

The analysis also found CDHPs are most popular in the Midwest. In that part of the country, CDHPs enrolled 19% of all covered employees. While CDHP enrollment was found to be lowest in the western U.S., it did increase from 10% in 2011 to 12% in 2012.

CDHPs include health savings accounts (HSAs) and health reimbursement accounts (HRAs). The analysis found that in 2012, 27% of large employers offered an HSA-based CDHP and 11% offered an HRA-based CDHP. When employees have a choice of medical plans, the average enrollment was found to be 40% for HRA-based plans and 27% for HSA-based plans. The AAPPO found that enrollment levels in both plan types are rising as employees become more familiar with them.

Other findings included:

  • CDHPs enrollment rose from 13% to 16% of all covered employees;
  • Forty percent of all employers expect to offer a CDHP in the next five years, either as the only plan offered or along with other medical plans; and
  • Sixty-eight percent of large employers expect the same.