A new survey focused on high-deductible health plans (HDHPs) finds that consumers often have differing attitudes and approaches to their health care, depending on what kind of plan they are enrolled in.

The 15th Annual Consumer Engagement in Health Care Survey, was conducted by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates. Officials with EBRI say the survey aims to examine consumer attitudes toward health care and health insurance, and that it provides data on consumer-driven plans and how they affect consumer health behaviors.

The latest report showed that growth of high-deductible plans has varied somewhat, but lately has been on an upward trend. "In 2019, 15 percent of privately insured adults had a plan that was associated with either a health reimbursement arrangement (HRA) or health savings account (HSA), collectively known as consumer-directed health plans (CDHP)," the report said. "Another 13 percent had a HDHP that was not associated with either an HRA or HSA."

However, the report also showed that HDHPs had peaked in popularity in 2013, when 18 percent of consumers were enrolled in such plans. That dropped sharply the next year, when only 11 percent were enrolled in HDHPs. That model has seen growth since. The CDHP plans had also seen a setback, in 2015, when enrollment went from 15 percent to 13 percent. Like HDHPs, CDHPs have grown in use since then, and are now again the choice of 15 percent of consumers.

Satisfied with service; less so with costs

The survey finds that both traditional plan members and high-deductible plan members have relatively high marks for health care services. Traditional plan members say they are extremely or very satisfied with the quality of their health care (67 percent), HDHP members are less satisfied but still a strong majority (59 percent).

In the area of costs, consumers are less satisfied. For traditional plan members, 40 percent report being extremely or very satisfied with their out-of-pocket costs for health care; 22 percent of high deductible members report that level of satisfaction. For out-of-pocket costs on prescription drugs, extremely/very high satisfaction is reported by 54 percent of traditional plan members and 35 percent of HDHP members.

Health plan choices, consumer research habits also tracked

The report notes that there is some variation when it comes to the number of health plan choices consumers have. About a third of both traditional and HDHP members say they have no choice in health plans. Traditional plan members were offered a choice of two or three health plans 17 percent of the time; HDHP members were offered two plans 22 percent of the time, and three plans 28 percent of the time. Four or more plans were offered to traditional plan members slightly more (15 percent) than HDHP members (12 percent).

The report also underscores the success HDHPs have had in making members more likely to shop for quality and cost differences. Consumers with HDHPs said they checked the quality ratings of a provider 45 percent of the time, compared with 36 percent for traditional plans. For costs, 46 percent of HDHP members checked before a visit, versus 35 percent of traditional plan members. And 55 percent of HDHP plan members checked on whether their plan would cover a prescription drug, compared with 42 percent of traditional plan members.

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Are employees happy with their health plan? Depends on what kind it is.

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