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Study Says Patients Unhappy with Consumer-Directed Health Plans

DECEMBER 8, 2005 -- Americans enrolled in consumer-directed health care plans are more likely to avoid or delay needed medical care and pay more of their own money for care when they do obtain it than people who are enrolled in comprehensive insurance plans, according to a new study released Thursday.

People who are sick and have low incomes and are enrolled in high-deductible health plans and health savings accounts are at the greatest risk of postponing needed health care, according to the study prepared by the Employment Benefits Research Institute (EBRI) and The Commonwealth Fund.

The study also concluded that individuals in consumer-directed health plans do exhibit more cost-conscious behavior in their health care decisions compared with those having comprehensive insurance. But it also found that very few people have the cost and quality information from their health plans to make informed decisions about their medical care.

"These findings provide evidence that high-deductibles and consumer-driven plans may undermine the two basic purposes of health insurance: to reduce financial barriers to needed care and protect against high out-of-pocket cost burdens for patients," said Commonwealth Fund President Karen Davis.

Proponents of consumer-directed plans have said they may be the ticket to controlling rising health care costs. By giving patients more responsibility for the health costs, the reasoning goes, consumers will spend their dollars more wisely.

Health savings accounts, or HSAs, are becoming a standard component of employer-provided health care, in part because insurers are marketing them aggressively and they are less expensive for businesses to offer than standard plans with lower deductible.

More than one million American workers have enrolled in the accounts since they became available at the beginning of this year, and the Joint Committee on Taxation estimates the figure will increase to 3 million by 2013.

Karen M. Ignagni, president and chief executive officer of America's Health Insurance Plans, a trade group representing health care insurers, said the EBRI-Commonwealth Fund study "confirms other research that has revealed widespread consumer satisfaction with a variety of coverage options offered by health insurance plans."

Ignagni also noted a study released earlier this year by McKinsey and Company that among consumers with HSAs, satisfaction levels did not vary with health status and that people with consumer-directed health plans were at least as likely to obtain preventative health care than consumers in traditional plans.

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