High Deductible Plans - Not Dead Yet

Earlier this week I tweeted out an article from EBN with a bit of a sensational headline: “Are high-deductible health plans and HSAs dead in the water?” The headline startled me because we’re still having conversations about consumer-directed strategies on a regular basis. (Not to mention that an increased emphasis on HSAs remains a key part of most Republican health care platforms.) Despite the headline, the article is worth reading – it points out that gains made by consumer-directed plans seem to be tapering off, and hypothesizes that more innovation is needed to sustain the movement.

On this last point, I definitely agree. I’ve long argued that slapping a high deductible health plan (HDHP) and Health Savings Account (HSA) on your employees is insufficient. Sure, you’ll likely save some money the first day when the deductible to your health plan is jacked up, but after that you’ll likely be right back struggling with difficult increases at renewal time. The real trick is bending the trend line, and I’d argue it is possible… but you’ll only realize real gains from a consumer-directed strategy if you truly engage employees and give them the tools they need to make better decisions. Engagement isn’t a deal-breaker for employers who are willing to put in the work. The trouble is the tools – they are usually hard to find, or not available at all.

As I mentioned in my post on intelligent network design, some carriers are getting better about making cost and quality data more readily available to members. It’s a no-brainer to communicate these tools to members when they have a HDHP and are – theoretically – putting in effort to make wise decisions with their money (and the plan’s). How can we tell members to make wise decisions but not empower them with the means to find answers? With these tools, members can get a sense of the cost and quality differences between different providers. Other third-party tools are available in this area as well.

One resource I’ve been talking about a lot lately - especially given the emphasis we’re putting on pharmacy management – is GoodRx. This is a really easy-to-use website members can use to get a sense of what prescriptions cost, and how the price may vary from pharmacy to pharmacy. As an example, I just plugged in a commonly prescribed drug – levothyroxine – to see how pricing varies at area pharmacies. I found that the drug costs 64% more at the local Albertsons than at WalMart. If you start encouraging members to take a look at this type of data before swiping their HSA card, it can have a real impact.

Alas, tools like GoodRx are the exception. Cost transparency remains elusive most of the time, and in the meantime we are left to wait and hope for the innovation called for in the EBN article.

Want to learn more about what tools are out there and move the needle on health care trend? Give us a shout at bayoubenefits@gmail.com