Employers slow to latch on to consumer-driven health plans.(Fixed Copayments May Wither)

WASHINGTON -- Consumer-driven health plans may be all the buzz in the health insurance industry, but employers have been wary of them so far, according to Randall Abbott, senior consultant at Watson Wyatt Worldwide in Philadelphia.

"The adoption of consumer-driven plans is very slow," he said at a conference sponsored by the American Association of Health Plans. "It has not been a revolution--it's really a very slow evolution."

In a survey of 434 large employers earlier this year, Watson Wyatt, along with the Washington Business Group on Health, found that only 6% of respondents have adopted health care reimbursement account (HRA)-style plans and 15% plan to offer one next year.

A typical consumer-driven health plan involves the use of an HRA to cover the first few thousand dollars in health care expenses. After that, patients pay out of pocket until their catastrophic coverage policies kick in.

"Large plans are reluctant to adopt consumer-driven health plans because they don't have a lot of confidence in them to solve problems," Mr. Abbott said. In particular, they are not sure that these plans will control costs or improve employee involvement in making cost-conscious health care decisions.

As employers try to figure out how to make workers more cost conscious about medical care, they are also are trying to pay more attention to employee lifestyle choices. "We've probably never been sicker than we are today," Mr. Abbott said, citing increasing rates of obesity and diabetes. "Seventy percent of plan costs are driven by modifiable lifestyle behaviors."

So far, employees have seen few consequences from their lifestyle choices. "We're going to change that, but we're not going to change it overnight," he continued. "There has to be motivation through financial means."