Does Enrollment in a CDHP Stimulate Cost-Effective Utilization?

Consumer-driven health plans (CDHPs) place the responsibility for cost sharing with consumers as they navigate the health care system. More information is needed as to whether, and to what extent, CDHPs are cost-effective.

This article details a two-year examination of employee health care utilization for employees from a Midwestern company. Study participants were 18,025 employees and their dependents. Comparisons were made between groups of employees who enrolled in a PPO (preferred provider organization) and those who enrolled in CDHPs the first and second years they were offered.

Key Findings: 

  • Utilization for employees in the PPO remained stable over the study time period. During the first year of enrollment in a CDHP, office visits, including high- and low-priority acute and chronic visits, were significantly lower than office visits for PPO enrollees.
  • In the second year of enrollment, differences in utilization were not seen for low-deductible CDHP enrollees as compared to PPO enrollees. High-deductible CDHP enrollees maintained reductions during the second year.
  • There were fewer reductions in office visits for salaried employees as compared to hourly employees.

Health care costs seem to be the determinant for choices about utilization as opposed to the priority level of care. A strategy that focuses on reducing low-priority care visits may prove more cost-effective.