Plan design and active involvement of consumers in their own health and healthcare.

OBJECTIVE

Underlying consumer-driven health plans (CDHPs) is the belief that the financial incentives, enhanced choices, and increased information will stimulate consumers to become active, informed managers of their own health and healthcare (ie, activated consumers). To examine this assumption, we assessed whether enrollees became more activated after enrolling in a CDHP and the degree to which those who were more activated adopted productive health behaviors.

METHODS

This was a longitudinal study of employees of a large manufacturing company where a CDHP was offered along with a preferred provider organization in 2004. Two waves of survey data were collected with a final sample size of 1616 employees.

RESULTS

The hypothesis that enrollees in a CDHP become more activated over time was not supported. However, the data suggest that those who were more activated were more likely to engage in the behaviors that CDHPs seek to encourage and to newly adopt these behaviors over time. This appeared to be true regardless of plan type.

CONCLUSION

Even though CDHPs do not appear to foster activation, they may provide a supportive environment for those who are more activated to manage their health. Encouraging enrollment based on enrollee readiness to take advantage of the CDHP environment may be more productive than relying on plan designs alone to activate enrollees once they are enrolled.