We have long cheered the rapid growth in consumer-driven health plans. Here’s more good news: Medical groups are increasingly covered by these policies. The American Medical Group Association just released a survey of its members:
The survey revealed that HDHPs along with CDHPs made up more than 1/3 of health plans analyzed and were as prevalent as PPOs. These plan types dwarfed HMOs, which made up only about 10% of analyzed plans.
The survey shows monthly HDHP and CDHP premiums are, on average, 80-85% of the premium of PPO plans. Medical groups also cover a slightly larger percent of the premium of HDHPs. Many groups with HDHPs include healthcare savings accounts with tax incentives or employer-funded reimbursement accounts for routine care. The yearly deductible for HDHPs is, on average, more than 4 times the deductible of PPO and HMO plans, exemplifying coverage focus on catastrophic illness.
The increasing prevalence of high deductible plans generally shows the desire of payers to hold consumers accountable for utilization and reduce unnecessary care. However, a lack of transparency of price and quality impacts consumer ability to make informed decisions about their healthcare resulting in consternation that reduction in needed care could counteract any gains made. Over 70% of the health plans analyzed within the survey were self-funded.
Over 40 health systems, hospitals and physician group practices from 23 states participated in the survey. Benefits data represent more than 16,000 physicians across specialties.
The use of the verb “dwarfed” to describe the
tiny share of HMO coverage is interesting. Physicians and their staff — by their behavior — are telling us that they trust themselves as consumers to keep health costs down and quality up better than they trust themselves as bureaucrats in a top-down system. This bodes ill for Obamacare’s ACOs, BPCIs, VBPMs, and whatever other acronyms are in the mix. The emphasis on “lack of price and quality” is also interesting. Physician: Health Thyself! If physicians and their own staff, when in the role of patients, are frustrated at this longstanding problem, there is hope for improvement.