Bus Week Article on CDHPs

In a special Business Week Report, Joseph Paduda (who writes the ManagedCareMatters blog) provides a critical summary of CDHPs (see CDHPs: No Rx for Health Care).  I think he makes several good points (although some of the commentors seem to disagree).

“The concept behind CDHPs is simple: People will be more careful about choosing which health-care services they buy if a big chunk of the dollars comes out of their own wallet.”  [As I have said before, I thought the original intent was to drive transparency and improved quality, but it is clearly about cost shifting (oh sorry I mean savings) today.]

1. Of all workers in employee health plans, the percentage enrolled in CDHPs went from 2.7% in 2006 to 3.8% in 2007.
2. employers hearing horror stories from employees about the myriad issues with CDHPs: no money in the deductible kitty, providers refusing to discuss price or negotiate post-treatment, health plans refusing to require providers to accept negotiated contract rates.
3. just 4% of large employers think CDHPs are “very effective” at controlling costs.
4. To be a smart consumer, one has to have information on pricing, quality, and results. Not only is this information sorely lacking, much of what does exist is complex and difficult to understand, requiring a good bit of in-depth knowledge of health-care terms and procedures.

“A RAND Corp. study concludes that when individuals are required to pay more for prescription drugs, they don’t take them as they should. As far as drug co-pays go, increasing consumers’ costs actually drives up total medical expenses. It’s not a great leap to think individuals with high deductibles will likely wait before scheduling an appointment with their physician to see if a problem just goes away on its own. That often leads to higher costs as the patient’s medical condition worsens and grows more difficult to treat.”