Consumer-driven plans haven't caught fire yet.(Practice Trends)

WASHINGTON -- Consumer-driven health care plans have yet to catch on with most patients.

These high-deductible spending accounts were designed to empower patients to make informed choices about their health care and provide them with more options regarding providers and treatments.

The large deductibles in consumer-driven plans may be too burdensome for some people to handle, Paul Ginsburg, Ph.D., said at a meeting sponsored by the Alliance for Health Reform. "People are going to go into debt. Some are going to declare bankruptcy because of the burdens of paying for medical care under this different benefits structure.

"What if it just causes a barrier to people getting care that they really need?" asked Dr. Ginsburg, president of the Center for Studying Health System Change (HSC). In his opinion, these problems are going to limit the extent to which these plans can be used.

Enrollment in consumer-directed health plans continues to grow steadily, but it remains "a tiny fraction" of all employer-sponsored coverage, according to a study in the journal HSR: Health Services Research. Dr. Arnold Milstein of Mercer Human Resource Consulting and Meredith Rosenthal, Ph.D., assistant professor of health economics and policy at the Harvard School of Public Health, found that patients in consumer-directed plans were more likely to enroll in tiered-benefit model plans or networks than in employer-funded health reimbursement accounts.

Tiered plans, which categorize hospitals or physician groups by price and quality and assign lower premiums or cost-sharing to patients who opt for a preferred tier, may offer more flexibility and choice to consumers. But as an HSC study indicated, employers seem to have doubts about the cost-saving value of any of these plans. In site visits to 12 nationally representative metropolitan communities, HSC found that few of the employers in these areas planned to adopt consumer-driven plans or tiered provider networks. ...