CDHP ENROLLMENT

In other CDHP news, enrollment in these high-deductible plans increased in 2007, but they still make up a small segment of the overall insurance market, according to recent research from EBRI/Commonwealth Fund.

The "Consumerism in Health Care Survey" shows that there are 2.3 million adults who had an account-based plan while another 5.2 million had an HSA-eligible plan but hadn't opened the account. The report also found that people enrolled in CDHPs are at higher income levels than in the past.

"It is hard to believe that CDHPs are the silver bullet," Fronstin continues. "Twenty percent of the population accounts for 80% of the spending. High deductibles alone will do very little to change the healthcare behavior of the highest users. I see CDHPs changing in the future. I see less emphasis on high deductibles and more emphasis on using cost and quality information to create incentives within benefit plans through more sophisticated cost sharing to engage consumers more in their healthcare."

Managed care executives need to think about better ways to educate plan participants, Fronstin says.

"If plan participants don't take advantage of the preventive benefits being offered by the plan, there could be a backlash because of misinformation and the benefits of preventive care won't be realized."

According to the survey, more than 50% of people with a CDHP reported that their deductible applies to all care, including preventive care. "We know from other studies that most plans carve out preventive care from the deductible," Fronstin adds.