Simplifying Consumer Driven Plans

Consumer driven health plans help address a change issue, by placing more financial and decision making responsibility with consumer. A separate question is, do they help simplify, or complicate health care for consumers or other stakeholders?

One could argue that anything that puts consumers more in charge will have some positive simplification effect, by diminishing the role of the health plan or provider in placing restrictions on the consumer.

But for all the positives reported with cost savings, personal engagement and other encouraging attributes, critics like The Commonwealth Fund lash out against the concept of High Deductible Health Plans. Now an article in the Wall Street Journal, while reporting on a just released General Accounting Office Report that critics are using to claims HSAs are the primarily the domain of the wealthy, also mentioned a number of service issues for members of consumer driven plans, which merit discussion.

Here's some issues the Wall Street Journal and others have raised:

• Health Savings Accounts can only be owned individually, causing a variety of issues for spouses covered by the high deductible policy
• Many health plans and HSAs aren't integrated, meaning information doesn't seamlessly flow from one to the other, requiring duplication of work, or a lag in available accurate information.
• For plans not integrated, sometimes the provider discounts that should be in place with the High Deductible PPO or HMO policies, aren't applied when paid from the HSA
• While employers can choose to purchase High Deductible Health Plans that have first dollar preventive care coverage, many choose plans without this feature, meaning members in such plans have to have their wellness and preventive services applied to the deductible requirement and pay them out of pocket.
• Many consumers are confused about the terms and provisions of such plans

Of course, consumer driven plans that are integrated with their HSA, have a debit card features to auto pay the consumer out of pocket expenses from the HSA, have easy to use and understand web portals and have proactively invested in ongoing employee communication on the plans, have taken important steps towards simplifying consumer driven plans for their members.

Those that haven't taken such steps continue to supply HSA and consumer driven plan critics rounds of live ammunition