For several years, consumer-driven health plans have been billed as a potential solution to soaring health-care costs — or at least to companies' share of such costs. CDHPs have made steady if unspectacular progress, with about one-third of companies now offering them and approximately 5 percent of workers enrolled in them.
But a new report from the Employee Benefits Research Institute claims that CDHPs are doomed unless companies fundamentally rethink the ways in which they communicate the virtues of such plans to employees. Lois Vitt, of the Institute for Socio-Financial Studies, and EBRI Fellow Ray Werntz argue that consumers face a daunting learning curve when it comes to navigating health-care choices on their own while simultaneously factoring in the financial implications of such choices. Given the traditional "top down" model of health care, the authors argue, consumers are ill-equipped to advocate for better or less-expensive care.
For CDHPs to succeed, Vitt and Werntz say, companies must partner with government, labor unions, health-care providers, and others to create new training programs that address health-care decisions and their underlying financial ramifications. Many CDHPs, for example, are offered alongside health savings accounts or health reimbursement accounts, the nuances of which escape most employees.
Employers have plenty of experience with employee education, of course, having worked hard to get them to appreciate the importance of saving for retirement via 401(k) and similar plans. Vitt points out that such efforts have fared poorly enough that many companies now offer a range of defaults, such as automatic enrollment, in an effort to overcome employee apathy or confusion. The challenge for CDHPs, she says, is that default arrangements are exactly what CDHPs are designed to move away from.