Blue Cross Blue Shield of South Carolina (BCBSSC) in January introduced a new program that many believe could revolutionize the Web-based self-service model.The program, known as Blue-By-Design, is a consumer- driven health plan (CDHP) that gives members the power to make their own healthcare decisions, says Terry Povey, director of Web business development, market research and statistics, for the Columbia, S.C.-based health insurer.
The plan features an employer-sponsored health savings account (HSA) and a medical plan with a high deductible. Members can choose from more than 600,000 healthcare professionals and facilities in all 50 states and abroad.
Other insurers are recognizing the value of CDHP. Mutual of Omaha, Omaha, Neb., introduced a CDHP to its portfolio of employee benefit coverages in June. Mutual of Omaha's CDHP is also a high-deductible medical plan coupled with an employer-funded reimbursement account for each employee.
The plan features three main components: a health reimbursement account, group health coverage (medical and prescription drug plans) and decision-support tools-such as online access to medical claims status, HSA account balances and prescription drug information.
"Personal involvement for these health-related decisions will help educate consumers about the true cost of care, and will make them more cost conscious," says Brad Utoft, vice president and product manager at Mutual of Omaha. "Individuals have always taken an insulated view of their health program. They don't see all the costs involved. CDHP puts these costs out in the open."
With a CDHP, a consumer is able to manage dollars independently. "They might have a $2,000 deductible while their employer places another $1,000 into a reimbursement account," explains Utoft. "Now, rather than making a doctor visit or requesting an antibiotic for a sickness, they might wait it out. And by saving on the cost of a doctor visit, the $1,000 in the pool is not depleted and can be rolled into the next year," he says.
The industry will keep its eye on how quickly the CDHP concept accelerates. A recent report, titled "Consumer- Directed Health Plans-Hope for Results and Unintended Consequences," from Conning Research & Consulting Inc., Hartford, Conn., states that CDHP penetration could be as great as 50% in the next five years.
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