Findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey

Abstract

This paper presents findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS). This study was based on an online survey of 3,887 privately insured adults ages 21-64 that was designed to provide nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs) and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with findings from the 2005-2007 EBRI/Commonwealth Fund Consumerism in Health Care Survey, and the 2008-2013 CEHCS. The 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey finds that 15 percent of the privately insured population was enrolled in a consumer-driven health plan (CDHP); 11 percent was enrolled in a high-deductible health plan (HDHP); and 74 percent was enrolled in more traditional coverage. Overall, 26 million individuals with private insurance were enrolled in a CDHP--a health plan associated with a health savings account (HSA) or health reimbursement arrangement (HRA), or an HSA-eligible health plan. This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. Specifically, those in a CDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctors about prescription options and costs; checked the price of a service before getting care; asked a doctor to recommend less costly prescriptions; talked to their doctors about other treatment options and costs; developed a budget to manage health care expenses; and used an online cost-tracking tool provided by the health plan. There is also some evidence that adults in a CDHP were more likely than those in a traditional plan to be engaged in their choice of health plan. Specifically, those in a CDHP were more likely than those with traditional coverage to say that they had attended a meeting where health plan choices were explained; consulted with their employer’s human resources (HR) staff about health plan choices; and were more likely to have consulted with an insurance broker to understand plan choices. The survey also finds that CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, as well as biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees.

Keywords: Consumer-driven health plans (CDHPs), Employment-based benefits, Health care attitudes and opinions, Health insurance attitudes and opinions, Health insurance coverage, Health reimbursement arrangements (HRAs), Health savings accounts (HSAs), High-deductible health plans (HDHPs), Wellness programs

JEL Classification: I1, I11, J3, J32