EBRI/Commonwealth Pan CDH Plans – Again

The Employee Benefits Research Institute and Commonwealth Fund have come out with their third annual survey of "Consumerism in Health." This edition is an improvement over earlier versions, though the commentary is every bit as negative as before. Under the headline, "Enrollment remains low," they say that consumer driven health plans (CDHPs) now cover 2% of the population. Yet, they also say that last year's survey found only 1% of the population being covered by CDHPs. This is a pretty amazing finding that should probably be headlined, "Enrollment in CDHPs Doubles in One Year!"

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  1. Dallas Salisbury says:


    Thanks for the update. And, for your notation on the value of the survey data. We will continue to work on the narrative as our goal is objective presentation. Our goal is continuous improvement. And, as you note, it is really the data that count. Hopefully with publication of the fourth survey (or 5th?……………..) you will be able to endorse the objectivity of the narrative as well as the value of the data.

    Dallas Salisbury
    President and CEO
    Employee Benefit Research Institute

  2. Devon Herrick says:

    EBRI Claims CDHC Enrollees Can’t Get No Satisfaction

    The Commonwealth Fund, which opposes consumer driven health care (CDHC), is always on the lookout for ways to criticize it whenever possible. A little over two years ago, they teamed up with the Employee Benefits Research Institute (EBRI) to publish the results of an annual, Internet-based survey on the experiences of enrollees in health plans with different levels of cost-sharing. Unfortunately, they see the glass as half empty despite ample evidence that many consumers think the glass is half full.

    The past three surveys all claimed enrollees are not as satisfied with CHDC plans as those in comprehensive plans. In the most recent survey, satisfaction rates were quite similar for the quality of care received (71 percent in CDHC plans compared to 74 percent in comprehensive plans). Satisfaction with plan doctors was also very similar across both groups. What supposedly most annoys CDHC enrollees is higher out-of-pocket spending — twice as many were dissatisfied with out-of-pocket spending (43 percent) compared to those enrolled in comprehensive plans (21 percent).

    Indeed, it is not clear what these conflicting results mean. Nearly two-thirds of CDHC enrollees (63 percent) reported having a choice of health plans, compared to only 54 percent of those in comprehensive plans. When asked why people chose their plans, 51 percent of CDHC enrollees reported lower cost of premiums; 46 percent because they could save money and rollover unused funds for later use. Twenty-eight percent of CDHC enrollees liked the ability to control their own health care dollars.

    Of those in comprehensive plans, 41 percent chose the plan for its low cost-sharing, while 29 percent chose it for low premiums. Controlling their own funds and savings for the future was negligible to them.

    About half (52 percent) of CDHC enrollees claimed their plan was the least expensive one among the ones they could choose from. Yet the in the same survey, 76 percent of CDHC enrollees “strongly” or “somewhat” agreed the plan would protect them from an expensive illness; compared to only 72 percent in comprehensive plans.

    This illustrates two different mind-sets in health coverage. One group prefers comprehensive plans with low cost-sharing despite higher premiums. Another group prefers lower-cost CDHC plans that allow enrollees to control some of their health dollars and save for the future.

    Overall, enrollees in comprehensive plans reported being more satisfied (64 percent claimed to be “extremely” or “very” satisfied vs. 47 percent in CDHC plans). In tallies of those who expressed any degree of satisfaction, 92 percent of enrollees in comprehensive plans were satisfied to varying degrees while the same was true for 85 percent of CDHC enrollees.

    On its face could this survey really mean enrollees dislike choice and control over their own funds? Or does it mean that workers think employer-sponsored health plans are free and (naturally) prefer pricy, comprehensive plans with little cost-sharing to ones they perceive shifts more costs and responsibility to them? If so, some CDHC enrollees may dislike their plan because they perceive a loss of benefits when their employer switched to CDHC plans.