Insurer: HRA Program Cuts Costs, Maintains Care

The study of 13,500 members of the Aetna HealthFund HRA, analyzing 2003 claims and utilization data, found that member utilization of some preventive care measures increased by as much as 23%.

According to the company, the program also appears to help effectively control health-care costs. Employers with the Aetna HRA experienced a 3.7% medical cost increase, compared to double-digit hikes for a similar population outside the plan.

The low medical cost increases for all members in the study were driven by two major factors: a reduction in certain physician visits, including an 11% drop in primary care office visits, and a modest 3% increase in specialist visits; and a reduction in utilization of facility services, including a 3% decrease in emergency room visits, a 14% decrease in outpatient cases, and a 5% decrease in inpatient admissions, Aetna said.

Aetna asserted that the program is also helping to control pharmacy costs and to encourage the usage of generic medications. Members experienced a 5.5% decrease in pharmacy costs driven by a 13% decline in overall prescriptions and a 7% hike in use of generic substitutes.

The insurer also found that about companies in its HRA:

• general adult preventive exams increased by 23%, compared to an 8% increase for a similar population
• gynecological exams increased 4% for both Aetna HealthFund members and a similar population
• child preventive exams for three to four year olds increased 4%, comparable to a 5% increase for a similar population; for five to nine year olds preventive care increased by 8%, compared to a 6% increase for a similar population

This study included employees from 19 different employers and compared 12 months (January through December) of 2003 claims and utilization data, to 12 months of experience for the identical group of members in 2002 prior to their joining Aetna HealthFund.