The Commonwealth Fund has concluded a study that finds a good deal of dissatisfaction with consumer-driven health plans (CDHPs).
This, of course, comes as a surprise to no one.
The organization I work for launched a high-deductible CDHP a little over a year ago. The enthusiasm for the product within the company was directly proportional to the lack of enthusiasm in the marketplace for it.
The idea behind a CDHP is simple: make consumers responsible for allocating their healthcare dollars. Under the influence of the market's "invisible hand," healthcare consumers with CDHPs should maximize their healthcare dollars by spending on procedures and drugs they actually need, as opposed to those they want (or, less cynically, think they need).
The two big assumptions being made about these healthcare consumers are: 1) they're capable of making informed decisions about their healthcare needs, and 2) they'll behave rationally. However, the Commonwealth Fund study suggests that neither of these things are occuring , despite finding that CDHP subscribers are significantly better informed about treatment options and the cost of care than healthcare consumers with more traditional healthcare coverage:
- More cost-conscious consumers. Among people in the plans who did receive care, there is evidence that they are more cost-conscious than those in comprehensive health plans. People in the CDHPs and HDHPs were significantly more likely to say that the terms of their health plans made them consider costs when deciding to see a doctor when sick or fill a prescription, to report that they had checked whether their health plan would cover their costs as well as the price of a service prior to receiving care, and to discuss treatment options and the cost of care with their doctors. Nevertheless, they were also more likely to go without care (emphasis mine).
Sadly, the study also found that whatever information CDHP subscribers weigh when making their healthcare decisions, little if any of it comes from their plan providers:
- Lack of information. Few health plans of any type provide cost and quality information about providers to help people make informed decisions about their health care. The study also found very low levels of trust in information provided by health plans (emphasis mine).
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