Segal Company

Consumer-Driven Health Plans

A consumer-driven health plan (CDHP) invites participants to become more involved in health care decisions and more aware of the true cost of care. An increasing number of health plan sponsors are turning to CDHPs in hopes of controlling costs without cutting benefits or raising contributions.

The implementation of a CDHP involves a significant effort on the part of the plan sponsor, and should not be done without considering the changes it would require from employees in terms of utilizing their coverage. In addition, deciding on the proper plan design, whether it be a Health Reimbursement Account (HRA)-based plan or an HSA option coupled with a High Deductible Health Plan (HDHP), and understanding the administrative and compliance challenges associated with each can be both confusing and challenging.

Segal can help you determine the best way to introduce health care consumerism to your plan participants. This may involve implementing a CDHP, modifying your current plan designs to increase participant cost awareness, launching a communications campaign for conscious decision making, or some combination of these methods.

Health care consumerism is not simply a plan design; it is a campaign dedicated to making participants better educated consumers of care. Segal can create the right strategy for your organization, using such services as:

  • A CDHP feasibility study to assess the readiness of your organization for new plans
  • Underwriting/plan design modeling to understand the value and costs associated with a CDHP and the impact one may have on your overall health benefit costs
  • Designing a CDH strategy and establishing long and short term goals to ensure success
  • Selecting vendors
  • Assessing your communications strategy. Even more than with traditional health plans, crafting the right messages and ensuring that participants understand what is expected from them are critical to success.
  • Creating communications to help participants make informed decisions regarding:
    • Which health plan they pick
    • Which treatment option they choose
    • Which doctor they choose
    • What lifestyle choices they make
  • Compliance guidance and review to ensure your plan is compliance with the rules that apply to CDHPs
  • Insight into other organizations' plans regarding consumerism, which is gained from our annual survey of consumer-driven health plans