Aetna study: CDHPs save money

An Aetna survey showed that members in its consumer-directed health plans (CDHPs), who held a Health Reimbursement Account (HRA) or High Deductible Health Plan (HDHP) with a Health Savings Account (HSA), instead of traditional PPO plans, save money while still getting quality care.

Aetna conducted the survey over a five-year period.

“The results confirm that members in consumer-directed plans are more engaged and active healthcare consumers-they are seeking increased levels of chronic and preventive care, they have higher rates of generic utilization, and they make greater use of tools and information, while demonstrating lower annualized medical cost increases,” says Aetna’s Head of Product Development Kathy Campbell.

For full-replacement HRA and HSA plans, annualized medical cost trend through five years of an Aetna HealthFund (AHF) plan is 4.5%, 2.5% lower than PPO trend over the same time period. This equates to a significant savings of more than $21 million per 10,000 members over the five-year period.

For employers who offer AHF plans as an option, they experience an annualized cost trend of 5.5% across all Aetna products over a five-year period, 1.7% lower than PPO trend over the same time period. This equates to a savings of more than $7 million per 10,000 members over the five-year period, based on the entire population, not just those who elected AHF, says Campbell.

In addition, plan sponsors that Aetna defines as "best in class" saw $23 million in savings per 10,000 employees over five years in the plans.

As far as consumer behavior goes, AHF members spend more on preventive care when compared with a control matched PPO population, indicating that AHF members have increased their usage of some preventive care services.

“Furthermore, the Aetna HealthFund member population showed 10% lower PCP utilization for non-routine services and 15% lower utilization of specialist care,” Campbell says.

Other observations include:
• Women in AHF plans access the same or higher levels of screenings for breast and cervical cancer as members in traditional PPO products, as do diabetics.
• AHF members with chronic conditions such as asthma, high blood pressure and high cholesterol use the prescription drugs necessary to treat their conditions at similar or higher rates than PPO members.
• Generic utilization for members of an AHF plan in 2007 was 60%, while in comparison, utilization of generic drugs among PPO members was 58.9%.
• AHF members use consumer tools and information at twice the rate compared with PPO members.

“When consumer-directed plans are implemented using a coordinated approach including benefit structure, information and tools, and a culture actively emphasizing and communicating consumerism concepts, employers can expect to achieve greater penetration and ultimately greater savings and improved employee health,” continues Campbell.

Through analysis, Aetna found cornerstones among the plan sponsors:
• Fostering a culture of healthcare consumerism among all employees, beginning with senior executives.
• Implementing a focused employee communication and education campaign.
• Offering wellness programs and incentives for healthy behaviors.
• Offering 100% coverage for preventive care.
• Carefully constructing a benefits package that includes appropriate levels of member responsibility.