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Studies show CDHPs control medical costs better than HMOs, PPOs

Posted On: Feb. 22, 2013 12:00 AM CST

Studies show CDHPs control medical costs better than HMOs, PPOs

Recent studies conducted by two of the largest U.S.-based health insurers indicate that employers sponsoring consumer-directed health plans have been substantially more successful in controlling medical costs than traditional HMO and PPO plans over the past several years.

Employees and dependents enrolled in one of Bloomfield, Conn.-based Cigna Corp.'s “Choice Fund” CDHPs reported an average 7% decrease in medical costs during their first year of enrollment, compared with an average 7% one-year increase among HMO and PPO enrollees, according to Cigna's seventh annual Choice Fund Experience Study.

Cigna's study, released last week, examined claim experiences among 1,900 client group plans covering more than 2.5 million individuals. Overall, Cigna said combined enrollment in its Health Reimbursement Arrangement and Health Savings Account CDHP programs grew by 26% in 2012.

Cumulatively, Cigna's group CDHP clients saved approximately $1,300 per employee in the first year, the study found. Per-employee savings compounded among CDHP clients in each subsequent plan year, totaling $7,800 by the fifth year.

In a statement accompanying the study, Cigna President and CEO David Cordani said the lower medical costs reported by CDHP enrollees are attributable in part to that group's higher rate of participation in health and disease management programs, as well as more frequent use of online pricing and quality-of-care rating indices.

Thirty-one percent of CDHP enrollees completed a health risk assessment in 2012, compared with 15% of HMO and PPO enrollees. Almost three-quarters of CDHP participants registered to use Cigna's online health care pricing directories and decision-making tools, compared with 47% of HMO and PPO plan members.

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“The evidence is clear, consistent and compelling,” Mr. Cordani said in the statement. “CDHP customers are more engaged with their health and health spending, they spend less to receive the same levels of recommended care, and are more satisfied with their health care experience.”

Hartford, Conn.-based Aetna Inc. reported similar results in its ninth annual “HealthFund Survey,” released Jan. 28. According to the study, Aetna clients that replaced their traditional group health benefit plans with one of the company's “HealthFund” CDHP plans saved an average of $350 per plan member per year.

Aetna's CDHP enrollees were 11% more likely to have received routine preventive care than HMO and PPO plan members, and were more likely to have been screened for certain types of cancer including cervical cancer (7%), colorectal cancer (8%), prostate cancer (10%) and breast cancer (6%) than traditional health plan members.

“Employers are trying to control rising health care costs by getting their employees to be more empowered when making health care decisions,” Tom Mafale, Aetna's head of national accounts sales, said in a statement accompanying the survey. “Encouraging people to receive the right care at the right time is one important way to help reduce health care costs for both employers and individuals.”