High-deductible health plans promote increased wellness program participation

Employer-provided healthcare continues to be the most common access to health insurance in the U.S., and as employers continue to look for ways to cut costs, consumer-driven high-deductible health plans continue to grow with the added benefit of increased employee engagement in healthcare choices.

Fourteen percent of the U.S. population was enrolled in a CDHP and 14% was enrolled in an HDHP, a slight increase for both from the previous year, according to the 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey.

And the number of workers who were in a CDHPs or HDHPs was more likely than those in a traditional plan to exhibit cost-conscious behaviors, according to a recent report from the non-partisan Employee Benefit Research Institute.

“This survey found that high deductibles are associated with new behaviors [that are] often encouraged by employers and insurers,” says Paul Fronstin, director of EBRI’s Health Research and Education Program and co-author of the report.

The theory behind CDHPs and HDHPs is that the cost-sharing structure is a tool that will be more likely to engage individuals in their health care, compared with people enrolled in more traditional coverage, the study suggests.

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And with the employees taking a bigger interest in their healthcare planning, employers are noticing their wellness programs taking a bigger role.

The study focused on three types of wellness programs: a health-risk assessment, a health-promotion program to address a specific health issue, and a biometric screening.

“CDHP enrollees and HDHP enrollees were more likely than traditional-plan enrollees to report that they tried to find cost information. They are also more likely to participate in wellness programs.” Adds Fronstin.

Specifically, 45% of CDHP enrollees reported that their employer offered a health risk assessment, compared with 34% of traditional-plan enrollees and 30% of HDHP enrollees. When asked about the availability of health-promotion programs, 53% of CDHP enrollees, 32% of HDHP enrollees and 41% of traditional-plan enrollees reported that their employer offered such a program.

Additionally, when asked about biometric-screening programs, 45% of CDHP enrollees reported that their employer offered such a program, compared with 36% among traditional-plan enrollees and 33% among HDHP enrollees.

CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to report that their employer offered a cash incentive or reward for participating in a biometric screening program. Seventy percent of CDHP and 67% of HDHP enrollees reported a cash incentive or reward for a biometric screening, compared with 51% among traditional-plan enrollees.

While these numbers represent self-reported awareness of available health and wellness programs and cannot be cross-referenced with objective data from employers and insurers, it is significant that, across the board, CDHP enrollees are aware and participate at higher rates in wellness programs, the author notes.

Another trend the study found was the increased interest in health savings accounts.

Among individuals enrolled in CDHPs, 56% opened an HSA, 19% were in an HRA, and 25% were enrolled in an HSA-eligible health plan but had not opened an HSA.

It’s more common for employers to contribute to HSAs than in the past, and the dollar amount is also increasing, EBRI says. Seventy-eight percent of CDHP enrollees reported that their employer contributed to the account in 2016, up from 67% in 2014.

Additionally, 20% of CDHP enrollees reported an employer contribution of at least $2,000 in 2016, up from 10% in 2014.

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