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2009年美国员工福利研究协会/美世全球消费者医疗保健参与度调查结果。

Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey.

作者信息

Fronstin Paul

机构信息

Health Research and Education Program, Employee Benefit Research Institute, Washington, DC 20005-4051, USA.

出版信息

EBRI Issue Brief. 2009 Dec(337):1-42.

Abstract

FIFTH ANNUAL SURVEY

This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21-64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21-64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment, whereas they were equally likely to report that they had access to a health promotion program. CDHP enrollees were more likely than traditional plan enrollees to participate when a program was offered. Among those not participating, they did not participate because they could make changes on their own; they lacked time; and they were already healthy. FINANCIAL INCENTIVES MATTER: Financial incentives for healthy behavior mattered more to CDHP enrollees than traditional plan enrollees. Financial incentives were a larger factor for CDHP enrollees than for traditional plan enrollees when it came to participating in wellness programs, choice of doctor, and the use of health information technology, as well as patient engagement using e-mail and the Web. HEALTH STATUS IS BETTER, INCOME HIGHER: Adults in CDHPs were significantly less likely to have a health problem than were adults in HDHPs or traditional plans. Adults in CDHPs and HDHPs were significantly less likely to smoke than were adults in traditional plans, and were significantly more likely to exercise. People in CDHPs were also less likely to be obese compared with adults enrolled in a traditional health plan. Adults in CDHPs were significantly more likely than those with traditional health coverage to have a high household income. CDHP and HDHP enrollees were also more likely than traditional plan enrollees to be highly educated.

摘要

第五次年度调查

本简报介绍了2009年员工福利研究协会(EBRI)/美国医疗管理协会(MGA)医疗保健消费者参与度调查的结果,该调查提供了关于消费者驱动型健康计划(CDHP)和高免赔额健康计划(HDHP)增长情况的全国代表性数据,以及这些计划和更广泛的消费者参与度对拥有私人医疗保险的成年人的行为和态度的影响。本次调查结果与此前的四次年度调查进行了比较。

参保率低但呈增长趋势

2009年,4%的人口参加了消费者驱动型健康计划,高于2008年的3%。高免赔额健康计划的参保率从2008年的11%升至2009年的13%。参加消费者驱动型健康计划的4%的人口代表了500万年龄在21至64岁之间拥有私人保险的成年人,而参加高免赔额健康计划的13%的人口代表了1620万人。在1620万参加高免赔额健康计划的人中,38%(即620万)报告称他们符合健康储蓄账户(HSA)资格,但没有此类账户。总体而言,1120万年龄在21至64岁之间拥有私人保险的成年人,占该市场的8.9%,他们要么参加了消费者驱动型健康计划,要么参加了符合健康储蓄账户资格但尚未开设该账户的高免赔额健康计划。

更具成本意识的行为

参加消费者驱动型健康计划的人比参加传统保险的人更有可能表现出一些具有成本意识的行为。他们更有可能表示自己已查看该计划是否涵盖某项护理;要求使用通用名药物而非品牌药;与医生讨论处方药选择、其他治疗方法和费用;请医生推荐成本较低的处方药;制定预算来管理医疗费用;在接受护理前查看价格;以及使用在线成本跟踪工具。

消费者驱动型健康计划更多地参与健康促进项目

参加消费者驱动型健康计划的人比参加传统计划的人更有可能报告称他们有机会填写健康风险评估问卷,而他们报告称有机会参加健康促进项目的可能性相同。当提供项目时,参加消费者驱动型健康计划的人比参加传统计划的人更有可能参与。在那些未参与的人中,他们不参与是因为他们可以自行做出改变;他们缺乏时间;并且他们已经很健康。

经济激励很重要

对于参加消费者驱动型健康计划的人来说,健康行为的经济激励比参加传统计划的人更重要。在参与健康促进项目、选择医生、使用健康信息技术以及通过电子邮件和网络进行患者参与方面,经济激励对参加消费者驱动型健康计划的人来说是比参加传统计划的人更大的一个因素。

健康状况更好,收入更高:参加消费者驱动型健康计划的成年人比参加高免赔额健康计划或传统计划的成年人患健康问题的可能性显著更低。参加消费者驱动型健康计划和高免赔额健康计划的成年人吸烟的可能性比参加传统计划的成年人显著更低,且锻炼的可能性显著更高。与参加传统健康计划的成年人相比,参加消费者驱动型健康计划的人肥胖的可能性也更低。参加消费者驱动型健康计划的成年人家庭收入高的可能性比参加传统健康保险的人显著更高。参加消费者驱动型健康计划和高免赔额健康计划的人比参加传统计划的人受教育程度也更高。

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