Consumers and their Health Care Coverage
The Employee Benefit Research Institute undertakes a regular survey of members in various types of health care coverage, which they define as CDHP, or high-deductible with a savings account, HDHP, high deductible with no savings account or traditional. (EBRI Report) From a survey conducted in 2011, the Institute finds that overall satisfaction at the very or extremely satisfied level among CDHP enrollees rose from 37% in 2006 to 52% in 2009 but dropped to 46% in 2011. For HDHP members, satisfaction stayed the same from 2006 to 2011, at 37%. In traditional plans, that level of satisfaction has actually fallen from 67% in 2006 to 57% in 2011. Satisfaction with quality of care (which it should be noted the plan likely has little to do with) rose for CDHPs from 63% to 71% over that time, for HDHPs it rose from 57% to 61% and for traditional plans it dropped from 76% to 71%. Enrollees in CDHPs and HDHPs were less likely than those in traditional plans to recommend the plan to coworkers or friends or to stay with the plan if they were given an opportunity to switch.
There was only a small difference among plan types in ease of getting doctor appointments, with 68% of traditional enrollees, 65% of HDHP enrollees and 73% of CDHP enrollees being extremely or very satisfied. Similarly, that level of satisfaction with provider choice was relatively equivalent among plan type, with 75% of traditional plan members, 71% of HDHP members and 78% of CDHP members. In regard to cost-sharing, as might be expected, traditional plan members have higher levels of satisfaction, at 41% in 2011, although that is down from 52% in 2009. HDHP enrollees bring up the rear with only 16% being extremely or very satisfied with out-of-pocket costs, roughly flat over the last six years. Twenty-four percent of CDHP members were satisfied in 2011, up from 20% in 2006 but down from a peak of 29% in 2009. The improvements in various types of CDHP satisfaction may be driven by members becoming more familiar with how to best use such plans. It is clear that as cost-sharing increases in all types of plans, satisfaction goes down.