Oct. 14—Health plans with high deductibles have become the second-most common type of employer-provided coverage, and they could grab the top spot within three years, according to a national healthcare benefits consultant.

Aon Hewitt’s 2013 survey of nearly 800 large and mid-size companies found 56 percent of employers offer so-called consumer directed health plans (CDHPs) that pair high deductibles with tax-advantaged savings accounts. Another 30 percent of such employers are considering offering CDHPs in the next three to five years.

The survey found CDHPs are the only insurance option for 10 percent of large and midsize employers, and 44 percent more companies are considering also limiting their employees’ options to those plans within the next three to five years.

The trends in employer offerings could drive employee enrollment changes. For instance, the Kaiser Family Foundation 2013 Employer Health Benefits Survey found most workers are still covered by PPO plans (57 percent), compared with 20 percent enrolled in high deductible plans, 14 percent in an HMO, and 9 percent in a POS plan. But the Kaiser survey echoed the Aon Hewitt findings of an accelerating trend toward the use of high deductible health plans: Only 8 percent of workers were covered by them in 2009.

The cost-savings appeal for employers of the CDHPs was reinforced by the Aon Hewitt survey’s findings that in 2012, employers reported a lower cost trend for CDHP plans (4 percent) than other plans, including PPOs (6 percent), HMOs (7 percent) and exclusive provider networks (6 percent).

“With many of the operational details of health care reform yet to be implemented, employers are confronting the realities of compliance and the significant challenges they face in controlling future health care costs,” Maureen Fay, senior vice president at Aon Hewitt, said in a release. “Employers are increasingly embracing plan designs that are cost-effective, promote consumer choice and accountability, and encourage employees to be more deliberate in how they spend their health care dollars.”

In addition to lower costs for employers, CDHPs can incentivize beneficiaries to become cost-conscious consumers of healthcare services. The rise in CDHP is one of the factors pushing providers to provide more price transparency, as consumers seek the ability to compare prices for elective testing and treatments.

Critics of the CDHPs worry the greater share of treatment costs borne by policyholders causes many to simply seek less care—both needed and unneeded.

Aon Hewitt found some employers include features in their HDHPs to mitigate potential unintended consequences, such as 44 percent of companies that offer the plans also covering preventive medicines before the deductible applies.

The Aon Hewitt survey also found high rates of enrollee satisfaction with such plan—more than three-quarters of consumers currently enrolled in a CDHP were satisfied with their plan choice (78 percent), and 89 percent said they planned to re-enroll.

Publication Date: Monday, October 14, 2013