Enrollment in consumer-driven health care stalls

Studies suggest Americans are slow to adopt new types of health plans, but experts say more education and communication are needed.

By Jonathan G. Bethely, AMNews staff. Dec. 25, 2006.

When PPOs were first introduced to consumers, the idea was slow to catch on, though now they cover most consumers in private health plans. Now, the buzz surrounding consumer-driven health care is not always translating into its adoption -- though supporters point to what happened with PPOs to say that enrollment in health savings accounts may well take off.

When given a choice among various health plans, only 19% of employees choose consumer-driven health plans, according to a study released recently by the Center for Studying Health System Change. Another recent study, this one by the Commonwealth Fund, finds that enrollment in consumer-driven health plans is virtually unchanged in 2006.

Consumer-driven health refers to plans in which patients have a greater financial responsibility for care than they would in an HMO or PPO. High-deductible insurance with health savings accounts are part of consumer-driven health, and the term HSA is used to describe that pairing. However, a high-deductible plan does not necessarily have a savings account component.

While both studies suggest a lukewarm response to the new health plans, Jeremy Lazarus, MD, vice speaker of the AMA House of Delegates and a psychiatrist from Denver, said it may be too early to judge the long-term success of consumer-driven health plans, considering it took 10 to 15 years before PPOs overtook HMO membership. The AMA has come out in support of HSAs and consumer-driven health care as part of an overall effort to give individuals more choice in their health care decisions. It also supports adoption of a consumer-driven, market-based plan using tax credits and insurance market reforms as a means to cut the number of uninsured.