CDHP, HDHP Participant Consumerism Doesn’t Improve Over Time

Consumer-directed health plan (CDHP) participants’ engagement does not increase as participants gain more familiarity with plan designs over time, according to an Employee Benefit Research Institute (EBRI) Issue Brief.

Cost-conscious decisionmaking also did not increase with time for participants in either traditional or high-deductible health plans (HDHPs).

EBRI found, however, it does appear that owners of health savings accounts (HSAs) are slightly more engaged the longer they have owned an HSA. Plan participants who have owned an HSA for 10 or more years are very likely to report (71%) that having an HSA has empowered them to make better health and financial decisions.

“It seems that the longer a participant has had an HSA, the more we see signs of engagement, like contributing $2,000 or more annually to the account,” says Paul Fronstin, EBRI researcher and co-author of the June Issue Brief, “The Impact of Length of Time Enrolled in a Health Plan on Consumer Engagement and Health Plan Satisfaction: Findings From the 2017 Consumer Engagement in Health Care Survey.”

Fronstin, who wrote the paper with Edna Dretzka of Greenwald & Associates, went on to explain that large contributions usually don’t appear instantly. “It takes participants some time to figure out how plans work,” he says, noting that, “once the plan design is better understood, participants are more likely to take advantage of the triple-tax advantages of an HSA.” He further explains that contributions to HSAs are exempt from taxable income in the year that they are made; the interest and capital gains in the account grow tax free; and withdrawals used for medical expenses are not taxable.