Half of consumer-directed health plan enrollees say they would be likely to switch plans if given the opportunity

Half of individuals enrolled in consumer-directed plans said they would switch out of the plans if given the opportunity, while about one-third of enrollees in more traditional employer-sponsored health plans said they would change their coverage if they had the chance, according to a survey released on Thursday by the Kaiser Family Foundation, the Washington Post reports (Lee, Washington Post, 11/30).

The Kaiser Family Foundation in June and July surveyed 272 people in consumer-directed plans -- individually purchased or employer-sponsored plans with high deductibles and either health savings accounts or health reimbursement arrangements -- and 715 in more traditional employer-sponsored plans. The survey found that more than half of individuals in consumer-directed plans who have received care under their plans said that being enrolled in such a plan has changed their approach to using health care, with 57% saying they changed because of cost considerations (Kaiser Family Foundation release, 11/29). In addition, the survey found that 71% of individuals in consumer-directed plans said the policies led them to consider cost when seeking medical care or filling a prescription, compared with 49% of those in traditional plans (Washington Post, 11/30). Thirty-nine percent of individuals in consumer-directed plans said they always or sometimes ask about cost before making a doctor's appointment, compared with 23% of individuals in traditional plans, according to the survey. Fifty-seven percent of individuals in consumer-directed plans said they always or sometimes ask about lower-cost alternatives, while 38% in traditional plans always or sometimes ask about such options, the survey found (Carey, CQ HealthBeat, 11/29).

Accessing Care
According to the survey, 23% of enrollees in consumer-directed plans said they have forgone needed care in the past year because of cost, about twice the percentage of enrollees in traditional plans who skipped needed care because of cost. In addition, the survey found that 26% of individuals in consumer-directed plans did not fill a prescription in the past year because of cost, compared with 15% in traditional plans (Simon, AP/Houston Chronicle, 11/30).

Obtaining Information
More than 60% of individuals in consumer-directed plans said it is difficult to find reliable information about the cost of physician and hospital care, and about 50% said it is difficult to find good information on the quality of care (Washington Post, 11/30). Nineteen percent of enrollees in consumer-directed plans and 10% of enrollees in traditional plans said they have used the Internet to find lower prescription drug prices, the survey found. In addition, the survey found that 5% of those in consumer-directed plans have used their plans' Web sites to compare the cost of different providers, and 7% have used the Web sites to compare quality. The percentage of individuals in traditional plans who used the Web sites was about the same as for those in consumer-directed plans (CQ HealthBeat, 11/29).

Comments
Devon Herrick, a health economist at the National Center for Policy Analysis, said, "It's a cultural shift. When you go to Wal-Mart you don't have to ask about price -- it's right there next to the good or service you are buying." He added, "Health care is not there yet, but it's getting that way. This is the early stages. We have incentives to get people more responsible and asking about price" (Washington Post, 11/30). Mohit Ghose, a spokesperson for America's Health Insurance Plans, said premiums for consumer-directed plans are often 30% lower than traditional plans and offer coverage to individuals who might otherwise not have any coverage (AP/Houston Chronicle, 11/30). Gail Shearer, director of health policy analysis at Consumers Union, noted the survey found that people enrolled in consumer-directed plans were more likely to be white and tended to be wealthier, healthier and more educated than those in traditional plans. "Instead of our health system moving towards one where we're all in this together, this type of option is leading to more splitting the population into different segments and, to me, that's an unhealthy thing," Shearer said, adding that lower-income, less healthy individuals could face future access problems (Washington Post, 11/30).

The survey is available online.