Aetna Program Shows CDHPs Contain Costs

The preliminary results from an Aetna study (2004) suggest that consumer-driven health plans (CDHPs) can be effective in controlling costs. In studying nearly 14,000 members in its HealthFund, Aetna found that medical costs increased only 1.5% and use of preventive care climbed by 16%. The study included employees from 19 different employers, and compared two similar periods of claims for the same members in 2002 and 2003.

Members in Aetna's HealthFund plan are allotted a specific amount of money in their health fund each year to pay for all health costs. A deductible applies after the balance is used, but once the deductible is met, the employee reverts to traditional health insurance coverage. The plan also allows rollovers of any unused balances and provides preventive care at 100% coverage.

Other key findings include:

• Preventive care visits increased by 30%, compared with a 14% increase for a similar population outside the plan.
• Members had a 6.5% decrease in pharmacy costs that were driven by an 11% decline in overall prescriptions and a 12.8% increase in an overall use of generic drugs.
• Member use of online consumer tools and information increased 11%.
• More than half of the members had fund dollars left to roll over into 2004. On average, those members rolled over 31% of their fund.
• Nine out of ten members said the fund met their expectations and an equal number said they were likely to renew their coverage.