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March 16, 2007
More Consumer-Directed Health Plans Offered, But Enrollment Remains Low

The percentage of large employers offering a consumer-directed health plan grew from 33 percent in 2006 to 38 percent in 2007, but employee enrollment remains low, at 8 percent and only one percentage point higher than in 2006, according to annual survey conducted by Watson Wyatt Worldwide and the National Business Group on Health.

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A consumer-directed health plan (CDHP) generally includes a high-deductible plan coupled with a health savings account (HSA) or health reimbursement account (HRA). Forty percent of employers now offer or plan to offer an HSA, and 26 percent offer or plan to offer an HRA.

The survey, which included 573 large companies, found that the portion of employers offering a CDHP has grown from 2 percent in 2002 to 38 percent in 2007.

"Curbing healthcare cost increases is a puzzle for employers, and consumer-directed health plans are only one piece," says Ted Nussbaum, Watson Wyatt's director of group and health care consulting in North America . "Employers can offer these plans, but it takes more than that to get employees to enroll. Filling in the missing pieces of quality, health management, and education will not only help employers solve the puzzle, but also make these plans more attractive to employees."

The survey found that employers with 10 percent or more of their covered population in a CDHP are holding healthcare cost increases to a lower level--6.5 percent average--than other employers. Some employers are also driving enrollment by offering CDHPs as their only option. Currently, 5 percent of employers are offering CDHPs on a total replacement basis, and another 4 percent will do so in 2008.

The survey also found that companies that are best at controlling costs are more focused on adopting approaches that involve quality, health improvement and productivity, data and evidence, and the appropriate use of health care services, says Nussbaum. For instance, best performers are 17 percent more likely to offer compelling financial incentives to encourage employee education and participation and 11 percent more likely to effectively deliver health care information.

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