Market watch: Who chooses a consumer-directed health plan?

Health Affairs

Volumn 27, Issue 6, 2008, Pages 1671-1679

  Barry, Colleen L ^a   Cullen, Mark R ^a   Galusha, Deron ^b   Slade, Martin D ^b   Busch, Susan H ^a  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b Department of Occupational and Environmental Medicine ^*

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONSUMER; COST CONTROL; HEALTH CARE COST; HEALTH INSURANCE; ADOLESCENT; ADULT; ECONOMICS; FEMALE; FINANCIAL MANAGEMENT; HEALTH SERVICES RESEARCH; HUMAN; MALE; MIDDLE AGED; NONBIOLOGICAL MODEL; ORGANIZATION AND MANAGEMENT; UNITED STATES; UTILIZATION REVIEW;

ADOLESCENT; ADULT; CONSUMER PARTICIPATION; FEMALE; FINANCING, PERSONAL; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH EXPENDITURES; HUMANS; MALE; MIDDLE AGED; MODELS, ORGANIZATIONAL; ORGANIZATIONAL CASE STUDIES; UNITED STATES; YOUNG ADULT;

EID: 56649105059     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.6.1671     Document Type: Article

References (19)

1. G. Claxton et al., "Health Benefits in 2007: Premium Increases Fall to an Eight-Year Low, while Offer Rates and Enrollment Remain Stable," Health Affairs 26, no. 5 (2007): 1407-1416.
2. See, for example, M.B. Buntin et al., "Consumer-Directed Health Care: Early Evidence about Effects on Cost and Quality," Health Affairs 25 (2006): w516-w530 (published online 24 October 2006; 10.1377/hlthaff.25.w516);
3. J.B. Fowles et al., "Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment," Health Services Research 39, no. 4, Part 2 (2004): 1141-1158;
4. S.T. Parente, R. Feldman, and J.B. Christianson, "Employee Choice of Consumer-Driven Health Insurance in a Multiplan, Multiproduct Setting," Health Services Research 39, no. 4, Part 2 (2004): 1091-1112;
5. and A.T. LoSasso et al., "Tales from the New Frontier: Pioneers' Experiences with Consumer-Driven Health Care," Health Services Research 39, no. 4, Part 2 (2004): 1071-1090.
6. L.A. Tollen, M.N. Ross, and S. Poor, "Risk Segmentation Related to the Offering of a Consumer-Directed Health Plan: A Case Study of Humana Inc.," Health Services Research 39, no. 4, Part 2 (2004): 1167-1188.
7. Jon Christianson, Stephen Parente, and Roger Feldman found that 8 percent of CDHP enrollees switched out after one year, compared to 5 percent of other enrollees, and that initial favorable selection disappeared over time. J.B. Christianson, S.T. Parente, and R. Feldman, "Consumer Experiences in a Consumer-Driven Health Plan," Health Services Research 39, no. 4, Part 2 (2004): 1123-1140;
8. and S.T. Parente, R. Feldman, and J.B. Christianson, "Evaluation of the Effect of a Consumer-Driven Health Plan on Medical Care Expenditures and Utilization," Health Services Research 39, no. 4, Part 2 (2004): 1189-1210.
9. S.H. Busch et al., "Effects of a Cost-Sharing Exemption on Use of Preventive Services at One Large Employer," Health Affairs 25, no. 6 (2006): 1529-1536.
10. J.W. Rowe et al., "The Effect of Consumer-Directed Health Plans on the Use of Preventive and Chronic Illness Services," Health Affairs 27, no. 1 (2008): 113-120.
11. The presence of two outpatient diagnostic codes, one inpatient code, or a filled (diabetes) prescription was used to classify disease status.
12. S. Nicholson et al., "The Magnitude and Nature of Risk Selection in Employer-Sponsored Health Plans," Health Services Research 39, no. 6, Part 1 (2004): 1817-1838.
13. Results are qualitatively similar for individual policyholders, although differences are not statistically significant by chronic condition.
14. M.L. Berk and A.C. Monheit, "The Concentration of Health Care Expenditures, Revisited," Health Affairs 20, no. 2 (2001): 9-18.
15. D.K. Remler and S.A. Glied, "How Much More Cost Sharing Will Health Savings Accounts Bring?" Health Affairs 25, no. 4 (2006): 1070-1078.
16. Nicholson et al., "The Magnitude and Nature"; and D. Altman, D. Cutler, and R. Zeckhauser, "Enrollee Mix, Treatment Intensity, and Cost in Competing Indemnity and HMO Plans," Journal of Health Economics 22, no. 1 (2003): 23-45.
17. J. Glazer and T.G. McGuire, "Private Employers Don't Need Formal Risk Adjustment," Inquiry 38, no. 3 (2001): 260-269.
18. Tollen et al., "Risk Segmentation."
19. M. Rosenthal, C. Hsuan, and A. Milstein, "A Report Card on the Freshman Class of Consumer-Directed Health Plans," Health Affairs 24, no. 6 (2005): 1592-1600.