Employee Satisfaction with CDHPs Grows

Consumer-driven health plans are gaining popularity among workers. What's driving this trend?

Wednesday, September 18, 2013
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New research from Washington-based Employee Benefit Research Institute shows that Americans with health insurance are becoming more comfortable with today's consumer-driven health plans. And with the cost of healthcare in America steadily rising (approximately 7 percent by the latest measure), more companies are providing their employees with health-savings accounts and high-deductible health plans, which lowers premiums and makes consumers consider costs.

According to Paul Fronstin, director of the institute's health research and education program, seven years of surveys about consumer engagement in healthcare reveal that "satisfaction levels trended up in most years of the survey among CDHP enrollees, and trended down among traditional-plan enrollees."

He adds that dissatisfaction levels with traditional plans had appeared to be trending downward in most years of the survey.

Fronstin says the results of the study come as no surprise to him, despite the sometimes-negative perception workers might have about plans that cost them more.

"When consumer-driven health plans were first introduced," he says, "they were confusing, but the longer you're on the plan, the more satisfied you'll be with it."So, now people [have been] on the plans longer, and they're happier with them," he says.

He advises HR leaders to invest more time in educating employees about their health benefits, especially as the system gets more complicated, says Fronstin, adding that a 15-minute open enrollment meeting isn't going to cut it. "The more time you spend really trying to educate people as to how the plan works will go a long way to helping people be more comfortable with it."

But such educational efforts take time, he says.

"John Deere spent 18 months educating people about their HSA before they introduced it," he says. "Maybe that's extreme, but it's very important to make people comfortable with it from the outset. Give employees detailed information about the accounts [such as] the interest rate, which preventative services are covered, and it would be very helpful for them to know when their employer will put the money into the account."

Principal and Senior Consultant Sander Domaszewicz of Mercer's health and benefits services, in Newport Beach, Calif., says he agrees that CDHPs have become more familiar -- and more accepted -- over time, but he also thinks that companies are getting better at administration and communication.

"Also, HSA balances are growing," he says, noting there is currently $19 billion in HSA accounts nationwide. "So, lower out-of-pocket costs translate to happier folks, [and that] adds to their satisfaction."

For consumers, healthcare pricing has typically been a mystery that wasn't revealed until the final bill was received, but, according to Domaszewicz, information on pricing is getting easier to locate.

"There's been a huge explosion in healthcare-transparency tools," he says, noting that companies such as Castlight Health, ClearCost Health and The Healthcare Blue Book provide pricing and quality information to health-plan participants before they seek care. "They're trying to come up with much more user-friendly versions of what the health plans have been doing in the past. They're trying to make these tools work much better for people."

When developing an implementation strategy for a new healthcare plan for employees, Domaszewicz says his most successful clients develop a communications strategy that delivers consistent messages with a mix of online and printed material, as well as face-to-face conversations. Online tutorials, modeling tools and flipbook surveys could also be offered on a routine basis to keep information current and employees engaged in the process.

But any information disseminated to employees about health insurance needs to be clear and simple, says Helen Darling, president of the Washington-based National Business Group on Health, a nonprofit membership organization representing large employers' perspective on national health-policy issues.

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"This is the hardest thing to do, but it can be done," she says, saying that benefits people often use code words that go over the average employee's head.

In educating employees about a new health plan, Darling says that examples are the best way to encourage employee engagement.

"For instance," she says, "Jane Smith is a single parent with two kids, and this is what happens if she takes her daughter to the doctor for . . . . Use the right words, and show what the plan would pay for and what she would have to pay for. Make it as close to reality as possible. Anticipate problems that could arise, and then give people a way to deal with them."

Darling adds that people often like to speak with a human being whenever they're having problems.

Online-shopping sites, she says, "often incorporate live chat pop-ups, which instills confidence in the consumer, because help is so readily available."

Such an accessible communication strategy often lets the consumer feel he or she is in charge, she says.

"So, within the first month or two of a new plan, it's a good idea to have 'live' people available to help employees."

While companies often outsource these particular jobs, Darling says it's important to have someone from within the organization act as a navigator for the company's covered workers.

"Back when we had managed care, people were very confused about it at the beginning," Darling says. "They thought it would be bad, and they wanted their old comprehensive-health insurance back, but it was a clunky system.

"However, people will have an innate resistance to change, and they want what they have, for the most part," she says. "Helping them to navigate the transition is really important."

And, she adds, "HR is all about being ready [to diminish employee] resistance."

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