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Article Excerpt
[ILLUSTRATION OMITTED]
THE CONVERGENCE OF RISING healthcare costs, increased cost sharing and demand by consumers for more participation in healthcare decisions is producing a variety of innovative health insurance solutions. Some of the new benefit designs focus on consumer engagement and incentives for healthy behaviors, while others are hybrids, filling a gap between traditional managed care and consumer-directed health plans (CDHP). In some cases, new plan designs are wrapping a healthy lifestyle component into a high-deductible structure.
Enrollment in CDHPs remains low but is growing, according to surveys by the Employee Benefit Research Institute and the Commonwealth Fund. Overall, 7.5 million adults ages 21 to 64 with private insurance, or about 7% of that market, were either in a consumer-driven or a high-deductible health plan in 2007.
"It's just too big of a jump to go from an HMO with copayments and no cost-sharing to a plan with high deductibles and cost sharing," says Kelly Smith, director of small group sales for CDPHP, an Albany, N.Y.-based insurer. The plan has offered transitional PPO and Exclusive Provider Organization (EPO) plans since early 2007.
BRIDGING THE GAP
CDPHP's...
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