Taking the pulse of consumer-driven health plans.(Consumer-Driven Health Care)

Thomas Weisman, MD, might be the last person you'd expect to be a foot soldier in a trendy new war on medical costs known as "consumer-driven health plans."

Weisman, 59, has a chronic disease that requires frequent visits to doctors and pharmacies. Nonetheless, in January, he switched from an Anthem Blue Cross and Blue Shield HMO to the company's consumer-driven health plan (CDHP).

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CDHPs, a nebulous euphemism for high-deductible PPO health insurance plans with savings account components, are considered niche insurance products for the young and healthy who eschew physicians and hospitals. They are not supposed to attract the middle-aged who expect greater out-of-pocket expenses.

But Weisman, an internist who is medical director for Anthem/WellPoint in the Northern Ohio region, did the math. Adding up payroll deductions for premiums of both plans, plus co-payments, deductibles and tax advantages, he computed saving about $700 annually. "I voted with my feet," he says. So did 15 percent of WellPoint employees when the CDHP was first offered this year.

It is this type of calculation that WellPoint and other insurers are betting will drive adaptation of the plans across ages and health status, reducing employer medical costs by an average 25 percent and attracting some of America's 46 million uninsured.

"I don't think this is a fad, and neither does my company, the largest health insurer in the country," Weisman says. "At the highest executive level, we have instituted a process to make sure we have a CDHP across all of our markets by January 2007. Our belief is that it's here to stay."

Insurer bandwagon

Clearly, enrollments are accelerating as more employers are requesting a CDHP alternative from insurers to offer to their workers. The largest U.S. health care companies--UnitedHealth, Aetna, Blue Cross, Cigna, Humana--are scrambling to feature them along with HMOs, PPOs and standard indemnity plans.

"Every large request for proposal is asking for a CDHP offering," says William Marino, president and CEO, Horizon Blue Cross Blue Shield of New Jersey.

Some insurers eager to jump on the CDHP bandwagon are buying HSA companies to give them a ready made product they don't have to invent from scratch, such as WellPoint's 2005 purchase of Lumenos, and United's purchase of Definity in 2004 and Golden Rule in 2003.

Twenty-nine percent of employers will offer CDHPs to employees in the next year, according to a June survey of 1,000 member agents and brokers of the National Association of Health Underwriters, Arlington, Va.

A few employers have even done "full replacements." For instance, Baylor Health Care System in Dallas had a full menu of plans in 2005 but made available only a CDHP to 14,000 employees for 2006. Wendy's International, Inc., did the same a year ago for its 12,000 eligible workers, switching from a single PPO plan in 2004 to multiple CDHPs in 2005.

And CDHP/HSAs will get a huge boost in January 2007 when the Centers for Medicare & Medicaid Services begins offering medical savings accounts/HSAs to Medicare Advantage beneficiaries as a demonstration project.

Advantage plans are generally insurance products where beneficiaries assign their benefits to an HMO or PPO. Medicare MSAs work similarly to Medicare HSAs except that HSAs are more flexible, offering…