The New Consumerism in Health Care

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The New Consumerism in Health Care Why States
Should Care Anne K. Gauthier Senior
Consultant, State Coverage Initiatives
AcademyHealth
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Consumer-Driven Health Care

• Overview
• High deductible insurance plan
• Personal account funded in various ways to pay
  for care
• Gap between the annual amount put into the
  account
• Internet-based decision support
• Potential Benefits
• Consumer control over health care and financial
  decisions
• Personalized information to facilitate decisions
• Greater choice of providers
• Incentives for consumers to control health care
  costs
• Potential Drawbacks
• Adverse risk selection
• Greater out-of-pocket costs for sicker and poorer
  consumers
• Information not yet sophisticated enough on
  quality

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The Many Names of CDHC

• The labels, structure, and the corresponding
  incentives of CDHC may vary
• Consumer driven or consumer-centric health plans
• Defined contribution health plans
• Medical savings accounts (MSAs)
• Health reimbursement accounts (HRAs)
• But, the direction of change is consistent!
• New Health Savings Accounts (HSA) allowances
  under the Medicare Modernization Act
• Greater employee cost sharing in all forms
  (premiums, deductibles, and coinsurance) across
  all plans

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Todays Session

• Consumer-Driven Health Care A National Overview
• (Tony Lo Sasso)
• Challenges and benefits to implementation from
  the employers perspective
• Definity case study
• Reducing Health Insurance Costs for Small
  Business
• (Bill Lindsay)
• Benefit design issues in todays health care
  environment
• An introduction to MSAs, FSAs, HRAs, HSAs
• Pressing Forward Cuts, Coverage Creativity
• (Mila Kaufman)
• Pros and cons of HSAs
• Policy issues and implementation for states

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Questions to Consider

• Will consumer-driven health care address the
  current health care crisis?
• How will providers, employers and consumers
  react?
• How will the Medicare Modernization Act change
  HSAs?
• What is the trend for the future?
• What do states need to watch?