Consumer-Directed Plans: Members See Lower Costs, Better Care

Hartford, Conn. - Aetna announced today the results of its broadest study to date of consumer-directed plans - a review of four years of data to determine the impact of consumer-directed health plans on 1.6 million Aetna members. Aetna is one of many insurers targeting members with improved tools and plans to improve overall performance and management of their members’ health. Included in the latest study were members in an Aetna HealthFund consumer-directed plan, as well as employees within the same employer groups who have chosen other benefits options. Five years after the launch of Aetna HealthFund, consumer-directed plans consistently result in lower medical costs, maintained or improved levels of chronic and preventive care, and increased usage of generic medications and consumer tools and information, the study results noted. The 1.6 million members studied include 134,000 HRA members from 99 employers, 18,000 HSA members from 27 employers, and 1.45 million Aetna members from those same employer groups who have chosen other benefits offerings. These members were compared to a population of 1.4 million Aetna PPO members comprised of all large employer groups. Four years of data was studied for HRA members, two years of data was studied for HSA members, and three years of data was studied for the comparison population. Among the study’s results, Aetna reports that it is receiving favorable reviews on its online tools: its HealthFund members accessed online tools more than twice as often as members of other plans, based on the experiences of five large employer groups. As consumer-driven products shift decision-making responsibility to consumers, other insurers are providing more information to help members make health care decisions. Highmark, Pittsburgh, Pa. contracted with Subimo LLC, a provider of Web-based health care decision support tools. Currently, 75% of Blue Cross Blue Shield plans in the United States use Subimo tools, and nearly 75 million Americans have access through their insurance company or employer. Using Subimo's Healthcare Advisor and Hospital Advisor, members can access health care information in both English and Spanish on hospitals, medical conditions and treatment options. Healthcare Advisor enables consumers to research treatment options, know what to expect prior to surgery and find the appropriate hospital for a certain health need. And Mount Laurel, N.J.-based AmeriHealth New Jersey plans to offer online capabilities through its Web site, www.amerihealthexpress.com, to its group customers and members, starting in 2007. Through a contract with Mount Pleasant, S.C.-based Benefitfocus.com Inc., AmeriHealth New Jersey will improve its self-service Web site by providing new Web tools to create an online resource for health benefit management. Other key findings from the Aetna study point to the ability of Aetna’s members to experience savings and improve their overall health focus: Employers who offered Aetna HealthFund as an option are seeing savings across all products offered. Those who offered an HRA option plan effective in January of 2003 experienced an average medical cost trend of 6.7 percent over a three-year period. Both Aetna HealthFund HRA and Health Savings Account (HSA) members with chronic conditions maintained or improved the level of care they received prior to joining the plan, including a 6% higher usage of inhaled steroids among asthmatics when compared to a similar population. Preventive care was also maintained or improved. For example, first-year HSA members received cervical cancer screenings at a 13.8 percent higher rate than PPO members.     Sources: Aetna, Business Wire, Insurance Networking News