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Consumer-directed health plans grew 27% in 2009

Although the growth rate was slower than for the previous year, these plans were still the only insurance products to show enrollment gains.

By Victoria Stagg Elliott — Posted May 5, 2010

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More people in 2009 than in 2008 signed up for high-deductible health insurance combined with some form of health savings or reimbursement account, and much of this growth is due to the increasing number of small businesses offering employees this option.

This is according to an analysis of Mercer's National Survey of Employer-Sponsored Health Plans released April 14 by the American Assn. of Preferred Provider Organizations.

"At a time when employers are faced with the difficult choice of limiting benefits or raising health care costs to their employees, they are turning to [consumer-directed health plans], given the cost savings inherent in these plans," said Karen Greenrose, RN, AAPPO's president and CEO.

An estimated 23 million people signed up for consumer-directed health plans in 2009, a 27% increase from the 18 million who did so in 2008. This is the only type of health insurance to show enrollment growth in 2009, so 9% of those covered by employer-sponsored health insurance now have this kind of plan.

The proportion of small employers offering this option grew from 9% to 15%, while participation by large employers held steady at 20%.

"This is actually a product that small employers continue to embrace," Greenrose said.

Growth also differed by region, with this form of coverage becoming much more common in the South and Midwest than elsewhere.

The increase nationally, however, was less than for the year before. According to data released by the PPO group in April 2009, CDHP enrollment went up 44%, from 12.5 million people in 2007 to the 18 million noted for 2008. About 6.5 million new people enrolled in the plans in 2008, and 5 million did so in 2009.

The latest research did not indicate why the rate of growth declined.

According to the survey, within the next five years, 11% of companies intend to offer a consumer-directed health plan as the only health insurance option, and 34% said they would offer it alongside others.

Those working on this issue, however, said it is unclear how consumer-directed health plans will fit in with recently passed health system reform legislation.

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