Planning, Public Policy & Management The University of Oregon June 26, 2006 Funded by Changes in Health Care Financing & Organization (HCFO), an initiative of the Robert Wood Johnson Foundation Testing the Assumptions Underlying Consumer Directed Health Plans

Setting  One large employer in the manufacturing sector  Employees are largely middle class. Compared to U.S. population overall, few employees with very low education or income, and disproportionately white  Company offered two HRA model CDHPs in 2004, alongside a PPO and an indemnity plan

Plan Details

Plan Enrollment Trends Enrollment by Year High Deductible CDHP Lower Deductible CDHP PPOIndemnity %23%60%4% %41%43%3% %54%26%4%

Plan Selection Plan Selection  High deductible CDHP enrollees were substantially healthier and had higher education levels than PPO enrollees (among hourly and salaried employees)  Lower deductible CDHP enrollees more closely resembled PPO enrollees, but were more consumer oriented Greene J, Hibbard JH, Dixon A, Tusler M. Which Consumers Are Ready For Consumer Directed Health Plans. Forthcoming in the Journal of Consumer Policy.

Data  Survey following cohort of ~ 2,000 employees  Conducted summer of 2004, 2005 & 2006  Oversampled CDHP enrollees, salaried and older employees  Phone and web-based  Topics: use of information resources, engagement in healthy and risky behaviors  Pharmacy & Medical Claims  Data from 2003 (year before introduction of CDHP) through 2005

Data Continued Qualitative component Focus groups with CDHP enrollees summer of 2004 In depth interviews with CDHP enrollees at another company in 2005

The authors wish to acknowledge both the participating employer and CDHP for their openness and commitment to research. We also would like to thank “The Changes in Health Care Financing and Organization” (HCFO), a program of The Robert Wood Johnson Foundation, for providing support for this research. Thanks