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Moderating health-care premium costs, employer skepticism and inadequate employee-educational efforts are contributing to lackluster enrollment in consumer-driven health plans, according to one health-care expert.

The 2007 Health Care Trend Survey released in Octoberby Findley Davies, an HR consulting firm, found slow adoption of consumer-driven plans -- and no significant future increases projected, says Bruce Davis, the firm's National Health and Group Benefits Practice leader, who is based in the Toledo, Ohio, office.

A consumer-driven plan is typically a high-deductible health-care plan coupled with a health-savings account or a health-reimbursement arrangement.

"I think it's probably several different reasons [for slow adoption and enrollment]," he says. "Many employers are taking a wait-and-see attitude [as] to whether these things really work or not and other employers are realizing this might be a viable strategy but, 'We are not ready for it yet.' "

Also, he says, moderating health-care premium costs means "there may not be as much of a compelling reason to put a CDHP in as there was two or three years ago. ... Maybe the sense of urgency that companies had to go in this direction may have diminished somewhat."

A recent analysis by Hewitt Associates found that U.S. companies saw the lowest health-care cost increase in eight years in 2006.

In addition to companies failing to provide sufficient information to allow employees to feel comfortable selecting a consumer-driven plan, Davis says another factor driving down enrollment is that employers offering such plans usually offer them as an option -- and do not provide any incentives to sign up, such as a drastically reduced payroll deduction. Offering such a reduced deduction, he says, is one reason why his own firm saw 60 percent of its employees sign up for the consumer-driven plan.

Another survey released in October, this one by the Dallas-based consultancy Pharmaceutical Strategies Group, found that of plan sponsors who offer a CDHP as an optional benefit, only 6 percent of employees enrolled in the plan.

It also found that less than 22 percent of national employers current offer consumer-driven health plans, the majority of them -- 72 percent -- being medium-large to large employers with more than 5,000 workers.

According to an annual survey by the Kaiser Family Foundation, a nonpartisan health advocacy group based in Menlo Park, Calif., about 2.7 million employees -- or 4 percent of employees with health insurance in 2006 -- are enrolled in consumer-driven plans.

The report found that about 7 percent of employers that provided health insurance for employees in 2006 offered such a plan.

In promoting the survey findings with various media, the foundation's president and CEO, Drew Altman, said such rates indicate "that the debate in the media and in Washington health-policy circles is way out in front of the reality" and that, "You can hardly say it's an idea that has taken the employer market by storm."

Davis said the findings of the Findley Davies survey of health-insurance underwriters¿representing millions of enrollees¿indicated no significant forecasts of CDHP adoption. Only two carriers projected an increase in enrollment -- by 1 percent -- from 2006 to 2007. Most of the surveyed carriers did not offer 2007 projections or offered a flat enrollment.

"I was just kind of surprised [at the results]," Davis says. "All of these carriers are in the market. They all have developed high-deductible health plans with HSAs or an HRA option. You get the feeling that some of them are doing that purely from a defensive standpoint because some of their competitors are doing it ... that they are not disciples of CDHP."