Shifting to a consumer-driven health plan is never easy for employers and employees alike.

Surveys show that many employees do not understand how the CDHP works, feel they lack enough ongoing support and tend to blame employers for the difficulties.

One way to avoid these pitfalls is year-round support with simple, focused communications.

That is the case with Midland Co., a property/casualty insurer in Amelia, Ohio, which moved to a CDHP in 2004.

Thanks to ongoing support and simple messages for its 1,300 employees, Elisabeth Baldock, senior vp-human resources and learning, said enrollment in the highest deductible level—where employees are most likely to weigh their health care decisions and the company saves the most money—has risen from 8% in 2005 to 22% today.

At the same time, Midland Co.'s medical claims last year were 10% lower than when it started the CDHP three years earlier.

"Our basic message is, 'You've got to stay away from the doctor and stay well,"' Ms. Baldock said.

Health Design Plus, the Hudson, Ohio, third-party administrator of Midland's self-insured plan, provides a secure Web site that shows employees their health care-related spending. It also provides a nurse hotline and a tool to help determine whether employees need to see a doctor.

In addition, Midland uses the AnswerSource Workforce Portal from Novato, Calif.-based Enwisen Inc.

Often, an insurer's Web portal does not provide employees with enough assistance to properly use a CDHP, said Barry Maxon, Enwisen's executive vp.

"The portal is all about the health plan and very little about the employer or employee," he said, noting that Enwisen's portals are branded for each employer and focus on the employer's specific plan design.

While AnswerSource can advise employees through e-mail or paper messages, Mr. Maxon said this is usually ineffective.

"The problem is that the timing isn't right," Mr. Maxon said. "When I get the message, I don't have an issue, so I throw it out. I only pay attention when I am actively seeking health care."

AnswerSource's approach uses an interactive search box that allows employees to type in questions in everyday language, such as "having a baby," and they are linked to information about maternity benefits. The portal also links to provider quality and cost information, a medical cost estimator, plan comparisons and sample questions to ask the doctor.

Health plan providers also are beefing up the online information they offer consumers.

Kerry Winkle, senior vp of strategic planning at Phoenix-based MphasiS Healthcare Solutions, which develops Web applications for health plans, said some CDHPs now offer physician performance data and tools to help determine whether a visit to the doctor or emergency room is needed.

Even though HR departments may be short on staff, "the employee wants to be able to ask someone a question," said Gregory J. Morano, chief executive officer of Univers Workplace Benefits in Hammonton, N.J. So Univers provides an outsourced help desk, versed in the design of its health plan.

Employers backed the interactive approach in a 2007 survey by Arlington, Va.-based Watson Wyatt Worldwide and Santa Monica, Calif.-based RAND Corp. In the survey, employers using CDHPs said tools such as plan cost calculators, online provider directories, health risk assessments and calls to HR were more effective than e-mails, mail to the office and home, and Webcasts.

Frank Kenna, president of Marlin Co. in Wallingford, Conn., offers another way to get messages across. Marlin's Electronic Communication Station, a flat-panel display screen, is placed in cafeterias and break rooms, providing "a consistent message that you know (employees will) see every day," Mr. Kenna said.

Targeted messages help lure employees onto Web sites, said Bobbi Coluni, director of consumer solutions at the health care business of New York-based Thomson Reuters, a news, information and services provider. An effective message, for example, offers an incentive, such as a payment $100 or more, for employees visiting the site and filling out a health risk assessment, she said.

Targeted communications can also correct employee misperceptions.

For example, a Thomson Reuters client discovered that CDHP enrollees were avoiding routine screenings because they mistakenly believed they weren't covered until the deductible was met. A major communication effort corrected this misperception and put utilization of preventive services back on track, Ms. Coluni said.