CDHPs: Challenges to Managing Workforce Health, Performance & Productivity

More employers are implementing consumer-directed health plans (CDHPs) as a way to lower their cost burden of health care benefits, but a new study from the Integrated Benefits Institute (IBI) examines whether this trend might result in lost productivity.

CDHPs are high-deductible plans offered in combination with an account that enrollees can access to offset the deductible expense. Premiums are generally lower than traditional plans because enrollees must meet the higher deductibles before traditional medical and pharmacy coverage begins. CDHPs have the potential to help contain health care costs and engage enrollees more fully in managing their health and health care decisions, and these plans are growing in popularity among employers. There are two main types of CDHPs: health savings accounts (HSAs) and health reimbursement accounts (HRAs).

The IBI report, “Consumer-Directed Health Plans: Challenges to Managing Workforce Health, Performance & Productivity,” found a potential downside of CDHPs: they shift more costs to employees, who will potentially forgo or delay necessary care. This finding echoed the concerns from an earlier survey conducted by the Benfield Group, on behalf of the National Pharmaceutical Council, that investigated pharmacy benefit designs in CDHPs.

IBI explained that if employees aren’t receiving the beneficial care they need, the outcome could be a decrease in workplace productivity. This unintended consequence could even exceed the costs of medical care for employers.

IBI also developed a list of questions for employers to consider when implementing a CDHP to avoid productivity losses:

  • Does the plan have a demonstrated strategy for informing enrollees of which services are covered for free or at low cost?
  • How does the plan facilitate employees’ abilities to shop around for services when it is feasible to do so?
  • Are there resources employees can consult to help them understand which care options are both indicated and of relatively good value?
  • Is there evidence that covered disease and lifestyle management programs improve health and reduce lost productivity for participants?