cdph poll final
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Sponsored by AETNA June 29, 2011
SHRM Poll: The State of Consumer-Directed Health Plans in the Workplace
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 2
Key Findings
How do organizations decide which health care benefits to offer? The most important (“somewhat important” or “very important”) considerations in selecting health care benefits were: 1) adopting new options that help contain costs for the organization (99%), 2) offering a health care benefits plan that provides a broad network of participating physicians and hospitals (98%), 3) adopting new options that help contain costs for employees (98%), and 4) providing 100% coverage for preventive care, including annual physicals and health screenings (95%).
Over the past three to five years, which cost-cutting measures have organizations implemented in relation to health care benefits? As the costs of health care continue to spiral upward, employees and employers are searching for ways to keep these costs under control and as manageable as possible. The top reported cost-cutting measures related to health care benefits was asking employees to share more of the cost of health care benefits (77%). This was followed by switching insurance carriers to find the most competitive rates (47%) and offering consumer-directed health plans (CDHPs) (41%).
Are companies leveraging consumer-directed health plans (CDHPs)? Yes; 42% of organizations offered a CDHP option for employees. Large-staff-sized organizations, publicly owned for-profit companies and firms with multinational operations locations were more likely to offer this plan. Among organizations that offered a CDHP, 75% offered health savings accounts (HSAs) and 47% provided health reimbursement arrangements (HRAs). *
How comfortable are HR professionals with their level of knowledge about CDHPs? In general, HR professionals were not entirely comfortable with their present level of knowledge about CDHPs: only 42% responded either “agree” or “strongly agree” when asked if they were comfortable with their level of knowledge. However, HR professionals from organizations that offered a CDHP were significantly more likely to agree (“agree” or “strongly agree”) they were comfortable with their knowledge level (55%) compared with organizations without this plan in place (34%).
*According to SHRM’s 2011 Employee Benefits Research Report, 35% of companies provided health savings accounts (HSAs) and 21% offered health reimbursement arrangements. The State of Consumer-Directed Health Plans in the Workplace poll specifically examined the relationship between HSAs and HRAs among organizations offering CDHPs.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 3
Key Findings
Do CDHPs help engage employees in their own health and wellness? Among respondents that offered a CDHP, 77% responded either “strongly agree” or “agree” that doing so has helped engage employees in their own health and wellness.
What are the barriers preventing organizations from offering CDHPs? Among companies without a CDHP, the primary reasons for not offering the option were: 1) management wants to maintain the status quo since most employees are satisfied with the current health care benefits plan (49%), 2) management believes CDHPs will not save enough money to merit offering this type of plan (27%), and 3) not have enough information about the benefits of CDHPs (26%).
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
In terms of a total compensation and benefits package, how important are each of the following to employees at your organization?
Vision insurance
Life insurance
Long- and short-term disability
Dental insurance
Employer match for defined contribution plan
Sick days
Prescription drug coverage
Vacation days
Health care benefits
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
21%
16%
15%
5%
8%
11%
1%
1%
1%
54%
52%
48%
39%
31%
28%
14%
11%
5%
24%
32%
38%
56%
61%
62%
85%
88%
95%
Not Very Important / Not At All Important Somewhat Important Very Important
4
Note: n = 836-853. “Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
In terms of health care coverage, how important are each of the following to employees at your organization?
Online tools with very specific information about health provider cost and quality ratings
Online tools with basic information to help educate employees
A tax-free fund of money to help pay for health care expenses
No referrals for specialty care
100% coverage for preventive care
Low out-of-pocket costs for prescription drug coverage
A broad network of participating physicians and hospitals
Low out-of-pocket costs for health care
0% 20% 40% 60% 80% 100%
34%
32%
22%
13%
2%
1%
2%
1%
49%
50%
50%
49%
31%
24%
21%
21%
18%
19%
27%
37%
66%
74%
77%
78%
Not Very Important / Not At All Important Somewhat Important Very Important
5
Note: n = 806-852.“Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
How important are each of the following to your organization when deciding which health care benefits to offer to employees?
Providing options that give employees control of their health care funds
24x7 access to credible health-related information and tools to educate employees and help them get the most from their health care benefits
Disease management programs for chronic conditions like diabetes and heart disease
100% coverage for preventive care, including annual physicals and health screenings
Adopting new options that help contain costs for employees
Offering a health care benefits plan that provides a broad network of participating physicians and hospitals
Adopting new options that help contain costs for the organization.
0% 20% 40% 60% 80% 100%
15%
14%
10%
5%
2%
2%
1%
43%
43%
44%
29%
23%
21%
13%
42%
43%
46%
66%
75%
77%
86%
Not Very Important / Not At All Important Somewhat ImportantVery Important
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Note: n = 822-840. “Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 7
Over the past three to five years, which of the following cost-cutting measures has your organization utilized to contain health care benefits costs?
Nothing
Other
Eliminating some (or even all) of the overall benefits that are offered to employees (i.e., the benefit no longer exists/is completely gone)
Reducing the scope and/or amount of overall benefits offerings from prior levels
Offering consumer-directed health plans (health savings accounts and/or health reimbursement arrangements)
Periodically switching insurance carriers to find the most competitive rates
Asking employees to share more of the cost of health care benefits--whether in the form of higher monthly premiums or out-of-pocket costs (e.g., deductibles, co-insurance)
5%
2%
15%
35%
41%
47%
77%
Note: n = 861. Totals do not equal 100% due to multiple response options.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Based on your experience with your own organization and its employees, do you agree or disagree with each of the following statements?
Our employees take an active role in choosing a health care benefits plan that will work for their unique needs.
It is a challenge to engage our employees in understanding how the health care benefits plan works.
It is a challenge to engage our employees in getting the best value from their health care benefits plan. It is a challenge to encourage our employees to focus on their
health and wellness.
Our employees consider their health care benefits to be an important part of their overall total compensation and benefits package.
0% 20% 40% 60% 80% 100%
44%
25%
23%
6%
43%
47%
44%
26%
13%
29%
33%
68%
Somewhat Disagree / Strongly Disagree Somewhat Agree Strongly Agree
8
Note: n = 827 - 846.“Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “strongly agree" responses.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 9
Do you agree with the following statement: “I am comfortable with my level of knowledge about consumer-directed health plans (CDHPs).”
Strongly Disagree
Disagree
Agree
Strongly Agree
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
15%
43%
35%
7%
Note: n = 821. “Not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 10
Does your organization currently offer consumer-directed health plans (CDHPs)?
Yes; 42%
No; 58%
Note: n = 838. “Not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 11
Does your organization currently offer consumer-directed health plans (CDHPs)?
1-99 employees = 32%100-499 employees = 41%
500-2,499 employees = 38%
2,500-24,999 employees = 60%25,000 and above = 63% Larger organizations > smaller organizations
Comparisons by organization staff size:Compared with smaller organizations (2,499 employees or fewer), larger organizations (2,500 or more employees) were more likely to offer a CDHP.
Publicly owned for-profit = 55%
Privately owned for-profit = 40%Nonprofit = 39%
Government = 33%
Publicly owned for-profit organizations > privately owned for-profit organizations, nonprofit organizations
and government agencies
Comparisons by organization sector:Publicly owned for-profit organizations were more likely to offer CDHPs than privately owned for-profit organizations, nonprofit organizations and government agencies.
Multinational operations = 54% U.S.-only operations = 39% Multinational operations > U.S.-only operations
Comparisons by operations location:Organizations with multinational operations were more likely than organizations with U.S.-only operations to offer a CDHP.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 12
Does your organization currently offer any of the following consumer-directed health plans (CDHPs)?
Health reimbursement arrangements (HRAs)
Health savings accounts (HSAs)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
47%
75%
Note: n = 344. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 13
Does your organization currently offer any of the following consumer-directed health plans (CDHPs)?
Multinational operations = 59% U.S.-only operations = 44% Multinational operations > U.S.-only operations
Health reimbursement arrangements (HRA) comparisons by operations location:Organizations with multinational operations were more likely than organizations with U.S.-only operations to offer HRAs.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 14
How easy or difficult is it to explain the concept of consumer-directed health plans (CDHPs) to employees?
Very Difficult
Somewhat Difficult
Somewhat Easy
Very Easy
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
11%
38%
44%
8%
Note: n = 342. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis. Percentages do not total 100% due to rounding.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 15
Do you feel equipped to explain consumer-directed health plans (CDHPs) as a health insurance option to the following groups?
Yes, feel equipped to explain CDHPs to employees
Yes, feel equipped to explain CDHPs to management
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
86%
90%
Note: n = 322-323. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 16
Has your insurance carrier provided you with the information you need to help educate the following groups about consumer-directed health plans (CDHPs)?
Yes, insurance carrier provided information needed to help educate employees
Yes, insurance carrier provided information needed to help educate management
81%
82%
Note: n = 310. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 17
Do you agree that offering a consumer-directed health plan (CDHP) has helped engage your employees in their own health and wellness?
Strongly Disagree
Disagree
Agree
Strongly Agree
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
6%
17%
53%
24%
Note: n = 322. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 18
Which of the following best describe your organization’s reasons for not offering consumer-directed health plan options?
Other
Management has difficulty understanding CDHPs.
Health care broker/consultant has not brought up CDHPs as an option for my organization.
Do not have enough information about the benefits of CDHPs.
Management believes CDHPs will not save enough money to merit offering this type of plan.
Management wants to maintain the status quo since most employees are satisfied with current health care benefits plan.
2%
17%
20%
26%
27%
49%
Note: n = 456. Organizations that offered consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis. Totals do not equal 100% due to multiple response options.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Demographics: Organization Industry
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Industry PercentageManufacturing 19%Health care and social assistance 15%Professional, scientific and technical services 13%Finance and insurance 10%Educational services 7%Public administration 5%Retail trade 4%Arts, entertainment and recreation 3%Construction 3%Information 3%Wholesale trade 3%Accommodation and food services 2%Religious, grantmaking, civic, professional and similar organizations 2%Utilities 2%Transportation and warehousing 2%
n = 861. Totals do not equal 100% due to multiple response options. * = Less than 1%.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Demographics: Organization Industry (continued)
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Industry PercentageAdministrative and support and waste management and remediation services 1%Agriculture, forestry, fishing and hunting 1%Mining 1%Real estate and rental and leasing 1%Repair and maintenance 1%Management of companies and enterprises *Personal and Laundry Services *Other services, except public administration 10%
n = 861. Totals do not equal 100% due to multiple response options. * = Less than 1%.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Demographics: Organization Sector
Government sector
Publicly owned for-profit organization
Nonprofit organization
Privately owned for-profit organization
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
10%
19%
20%
51%
21
n = 859.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Demographics: Organization Staff Size
1 to
99
emplo
yees
100
to 4
99 e
mplo
yees
500
to 2
,499
em
ploye
es
2,50
0 to
24,
999
emplo
yees
25,0
00 o
r more
em
ploye
es0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
25%
39%
18%13%
5%
22
n = 859.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
Demographics: Other
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n = 860.
U.S.-based operations only 83%
Multinational operations 17%
Single-unit company: A company in which the location and the company are one and the same
41%
Multi-unit company: A company that has more than one location
59%
Corporate (companywide) 73%
Business unit/division 16%
Facility/location 12%
Is your organization a single-unit company or a multi-unit company?
Are HR policies and practices determined by the multi-unit corporate headquarters, by each work location or both?
Does organization have U.S.-based operations (business units) only or does it operate multinationally?
n = 861.
n = 503. Percentages do not total 100% due to rounding.
The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011
SHRM Poll: The State of Consumer-Directed Health Plans in the WorkplaceSponsored by AETNA
Response rate = 14% Sample composed of 861 randomly selected HR professionals form
SHRM’s membership database with the job title of manager and above
Margin of error is +/- 4% Survey fielded June 8th - June 20th, 2011
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Methodology
For more poll findings, visit www.shrm.org/surveys
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