Employees who choose to participate in consumer-driven health plans (CDHPs) usually have higher incomes and education levels, according to new research.

CDHPs are usually high-deductible health plans, often account-based with a health reimbursement arrangement (HRA). Their enrollees also tend to report better health behaviors, according to the Employee Benefit Research Institute's evaluation of data collected from 2005 to 2011. About 21 million Americans were covered through a CDHP in 2011, EBRI reports, accounting for approximately 12 percent of the market.

"Consumer-driven health plans are a growing presence in the health insurance market, so it's important to understand how they differ from traditional health plans," stated report author Paul Fronstin, director of EBRI's Health Research and Education Program. "It is often assumed that CDHP enrollees are more likely to be young than those with traditional coverage, because they use less health care, on average. However, in most years, the survey found that CDHP enrollees were less likely than those with traditional coverage to be between the ages of 21 and 34."

CDHP plan enrollees were found to be less likely to smoke and more likely to exercise regularly, although researchers note that this data is self-reported and might be impacted by the design of their insurance plan. In six of the seven years examined, the report indicates CDHP participants were more likely to report themselves in very good or excellent health, when compared to those in traditional health insurance benefit programs. They were also about twice as likely to have a college or postgraduate education as Americans enrolled in traditional plans.

Spread and impact of CDHPs

A growing number of public and private employers have been turning to account-based, high-deductible health insurance policies in recent years. The combination of deductible and premium levels common to such plans seems to offer a balance between limiting costs to insurers, insured and employers sponsoring the plans. Concern over healthcare costs has become more prominent at all levels of government and among private firms, but some researchers say that the advantages these plans offer have certain risks attached, according to Reuters.

A study published in the May issue of Health Affairs indicates that CDHPs could save 4 percent in healthcare costs for the nonelderly if they made up half of the employer-sponsored insurance market, compared to the current 13 percent. Statistician Amelia Haviland of Carnegie Mellon University led the Rand Corp. study, and suggested that such an increase in CDHP use is plausible if cost pressure and Affordable Care Act incentives remain in play.

At the same time, the report indicates a lack of certainty surrounding the impact of up-front patient cost increases and other changes. Families covered under CDHPs might be choosing to pass up on recommended screenings and procedures in order to save, as well as making fewer visits to health professionals.  Some are also concerned that higher enrollment in CDHPs by those who need less care could increase the cost of traditional plans for Americans who have greater medical care needs, according to the news source.

School districts should consider HRAs and CDHPs when looking at their different coverage options and negotiating collective bargaining agreements with teachers. Account-based plans can provide some useful tax advantages to participants, in addition to their tendency to have lower premiums, which could help individuals balance their budgets while state and local officials try to improve government finance.