Verdict on CDHC: Patient Power Works
Cigna has released a report on its Choice Fund, culled from 5 years of real-world experience with 897,000 plan members, about half in “traditional” coverage and the rest in consumer-driven plans. All of the metrics show that consumer driven (CD) health is working beyond anyone’s expectations.
In cost control, the CD Health plans save 15 percent in the first year, and it grows over time – 18 percent in year two, 21 percent in year three, 24 percent in year four, and 26 percent in year five. All this while individual out-of-pocket exposure is about the same (17 percent) in both plans.
In improving quality, there is 8 percent to 10 percent higher use of preventive services in the CD Health plan, and CDH enrollees are 9 percent more likely to get evidence-based treatment in the first year and 14 percent more likely in the second year of enrollment. They are five times more likely to complete a health risk assessment and 19 percent more likely to work with a health advocate. CDH enrollees are 40 percent more likely to use on-line cost and quality tools when making decisions.
There is a 13 percent decrease in the use of emergency rooms, and CDH enrollees are 9 percent more likely to switch to generic drugs. They lower prescription costs by 14 percent.
For chronic disease management, CDH enrollees are 21 percent more likely to participate in a disease management program and reduce their costs by 21 percent for joint disease, 8 percent for diabetes, and 7 percent for hypertension.
Finally, in a change from previous reports, CDH enrollees are slightly more satisfied with their plans than people in traditional approaches (83 percent versus 82 percent).
HT to Consumers for Health Care Choices. Full CIGNA report.
Of course, CDHC works. Every worthwhile study has come to that conclusion.
This is consistent with everything else I’v read.
Of course, patient power works. Are there still any doubters?
They do not give any details on patient selection. Do you have any? How do you rule out selection bias?
Steve
It should be self-evident that incentives work. The Cigna Choice Fund would work even better if enrollees were shopping in a medical market that actually resembled a real market. Health care consumers are stuck in a marketplace that does not really know how to compete for their business.
Steve–the American Academy of Actuaries addressed the self-selection issue in their 2009 monograph. They say that all of the studies they looked at “used some variation of normalization or control groups to account for selection bias.”
Obviously that isn’t a perfect control. But more important is the fact that the same result has been found to be true for all kinds of populations including people on Medicaid.
@Linda- I am familiar with the Actuaries report. They do not control for self selection. IIRC, they were planning a larger study to look at this.
Steve