THE COMMONWEALTH
FUND
Early Experience With High-Deductible and Consumer-Driven
Health Plans:Findings from the
EBRI/Commonwealth Fund Consumerism in Health Care Survey
Paul Fronstin, EBRI and Sara R. Collins, The Commonwealth Fund
EBRI Policy Forum, Washington, D.C.December 8, 2005
THE COMMONWEALTH
FUND
MethodologyThe Consumerism in Health Care Survey was conducted online using Harris Poll Online, Harris Interactive’s online sample of Internet users.
Eligibility: Americans ages 21 to 64 with private health insurance coverage.
Stratification: Gender, age, and region.
Final sample is skewed towards higher income, more educated, and also under represents minorities.
Weighting: The national sample is weighted by gender, age, region, and education to reflect the actual proportions in the population.
The CDHP and HDHP samples are unweighted, since population data does not exist.
Analysis Groups: Comprehensive insurance, HDHP, CDHP
Sample Groups: National sample Oversample
n=1204 (1061 Comprehensive, 126 HDHP, 17 CDHP)
n=505 (337 HDHP, 168 CDHP)
1. Comprehensive n=1,061 (all from national sample)
2. HDHP sample n=463 (126 – national, 337 – oversample)
3. CDHP sample n=185 (17 – national, 168 – oversample)
THE COMMONWEALTH
FUND
Health Plan Definitions
• Comprehensive – plan with no deductible or <$1000 (individual), <$2000 (family)
• HDHP – plan with deductible $1000+ (individual), $2000+ (family), no account
• CDHP – plan with deductible $1000+ (individual), $2000+ (family), with account
THE COMMONWEALTH
FUND
Respondent ProfileComprehensive
(n=1061)HDHP
(n=463)CDHP
(n=185)
Age 21 to 34 29% 17%* 21%*
Education High school graduate or less
32 8* 5*
College graduate or some graduate work
23 38* 46*
Graduate degree 11 17* 21*
Household Income $150,000 or higher 4 3 9*
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Respondent ProfileComprehensive
(n=1061)HDHP
(n=463)CDHP
(n=185)
Self-Rated Health Status
Excellent/very good 45% 47% 57%*
Obese 36 33 26*
Smokes cigarettes 23 14* 14*
No regular exercise 24 15* 16*
Firm Size Self-employed with no employees
2 9* 8*
2-49 15 31* 38*
50-199 9 9 8
200-499 10 7 5*
500 or more 55 37* 36*
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Distribution of Individuals Covered by Private Health Insurance, by Type of Health Plan
HDHP
9%
CDHP
1%
Comprehensive
89%
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Number of Years Covered by Current Health Plan, by Type of Health Plan
1921
46*
302725
5354
24
0
20
40
60
80
Comprehensive HDHP CDHP
Less than one year 1-2 years 3 or more years
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Familiarity with Consumer Driven Health Plans
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
4
65*
10*
14
22*
24*
80
13*
50*
0% 20% 40% 60% 80% 100%
CDHP
HDHP
Comprehensive
Extremely or very familiar Somewhat familiar Not familiar
THE COMMONWEALTH
FUND
Deductibles, by Type of Health Plan
Comprehensive (n=1061)
HDHP (n=463)
CDHP (n=185)
Individual Deductible No deductible 47%
$1 - $499 29
$500 - $999 13
$1,000 - $1,999 64 39
$2,000 - $3,499 23 49
$3,500 or higher 8 10
Family Deductible No deductible 48
$1 - $499 17
$500 - $999 14
$1,000 - $1,999 13
$2,000 - $2,999 50 31
$3,000 - $4,999 22 43
$5,000 or higher 20 24
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Satisfaction with Quality of Health Care Received, by Type of Health Plan
4
23
72
14*
34*
52*
28
9*
63*
0
20
40
60
80
Extremely or very
satisfied
Somewhat
satisfied
Not satisfied
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Satisfaction with Out-of-Pocket Costs for Health Care, by Type of Health Plan
21
3642
31
12*
57*
18*28*
54*
0
20
40
60
80
Extremely or very
satisfied
Somewhat
satisfied
Not satisfied
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Satisfaction with Choice of Doctors, by Type of Health Plan
6
21
73
11*
29*
60*
1021
69
0
20
40
60
80
Extremely or very
satisfied
Somewhat
satisfied
Not satisfied
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Overall Satisfaction with Health Plan, by Type of Health Plan
8
28
63
29*39*
33* 3226*
42*
0
20
40
60
80
Extremely or very
satisfied
Somewhat
satisfied
Not satisfied
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Likelihood of Recommending Health Plan to Friend or Co-Worker, by Type of Health Plan
2426
5143*
34*
22*31 35*34*
0
20
40
60
80
Extremely or very
likely
Somewhat likely Not likely
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Likelihood of Staying With Current Health Plan If Had the Opportunity to Change, by Type of Health
Plan
11
28
61
33*37*30*
2133*
46*
0
20
40
60
80
Extremely or very
likely to stay
Somewhat likely
to stay
Not likely to stay
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Agreement With Statements About Health Plan: Percent Reporting That They Strongly or Somewhat
Agree, by Type of Health Plan
5346
7769
39*40
67*50* 46
75
41*54*
020406080
Health plan is easy
to understand
Health plan will
protect me in the
event of an
expensive illness
Health plan
encourages me to
adopt a healthier
lifestyle
Health plan provides
information to help
me choose among
physic ians,
pharmac ies, labs,
and hospitals
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Attitudes About Consumerism and Quality
71
64
50
9
70
68
46
10
74
67
9
41*
In general, the choices made by thepeople who use health care services
have a significant impact on the total costof health care
In general, the choices made by thepeople who use health care services
have a significant impact on the quality ofhealth care they receive
It is possible to find information you cantrust about the quality of health care you
receive
In general, doctors who charge higherprices provide higher quality health care
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Percentage of Individuals Covered by Employment-Based Health Benefits With No Choice of Health
Plan, by Type of Health Plan
34
52*51*
0
20
40
60
80
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Among Individuals with a Choice of Plan, Reasons for Choice
• Comprehensive– Low out of pocket costs, good benefits (54%)
• CDHP (n=63)– Opportunity to save money in the account,
and rollover funds for future years (62%)
• HDHP– Cost of the premium (64%)
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Health Plan Choice and Premium Cost
12
29
27
21
11
32
31
14
24
10*
50*
5*More expensive than all the other plans
More expensive than some, but less expensivethan others
Less expensive than all the other plans
About the same cost as the other plans
Comprehensive HDHP (n=279) CDHP (n=114)
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Percentage of Individuals With Comprehensive Employment-Based Health Benefits
Offered CDHP or HDHP
Offered a CDHP or HDHP
33%
Don't know if CDHP or HDHP was offered
26%
Not Offered a CDHP or HDHP
41%
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Reasons HDHP Members Give for Not Selecting a CDHP Plan That Was Available
18
19
30
10
15*I did not like the high out-of-pocketcosts
I am more familiar with the plan Iselected
It is too much trouble to open and/ormanage the savings account
I did not have the money to put into asavings account
It's too complicated, I did notunderstand it
HDHP (n=136)
Note: HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account.
*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05
or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Issues Not Addressable
• Employer contributions• Individual contributions• Rollover amounts• Choice:
– Reasons why those in CDHP chose plan– Reasons why those in comprehensive did not
choose CHDP
THE COMMONWEALTH
FUND
Implications of Consumerism For:
• Out-of-pocket costs • Access to health care services• Information on cost and quality
of providers• Health care decision making
THE COMMONWEALTH
FUND
Percent of Income Spent Annually on Out-of-Pocket Medical Expenses
8 1216
30*
21*14*
11640
20
40
60
ComprehensiveHDHP
CDHP
ComprehensiveHDHP
CDHP
ComprehensiveHDHP
CDHP
10%+ of income 5-9% of income
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.**Health problem defined as fair or poor health or one of eight chronic health conditions.Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64 spending ≥ 5% of income
TotalHealth Problem**
<$50,000 Annual Income
5
20*
118
29*16
14
45*
23
6* 8*15*
731 1 3 3
(n = 61)
(n = 90)
THE COMMONWEALTH
FUND
Percent of Income Spent Annually on Out-of-Pocket Medical Expenses, Including Premiums
9 13
2529*
35*
58*
23* 26*
44*
0
20
40
60
80
100
ComprehensiveHDHP
CDHP
ComprehensiveHDHP
CDHP
ComprehensiveHDHP
CDHP
10%+ of income 5-9% of income
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
**Health problem defined as fair or poor health or one of eight chronic health conditions.Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64 spending ≥ 5% of income
Total Health Problem**<$50,000
Annual Income
12
42*31*
17
38*34
92*
66
53*
13* 9*18* 12* 10
33* 213 4
(n = 61)
(n = 90)
THE COMMONWEALTH
FUND
Percent of Adults Who Have Delayed or Avoided Getting Health Care Due to Cost
2621
17
42*
31*31*35*
48*40*
0
20
40
60
Total Health Problem** <$50,000 Annual
Income
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
**Health problem defined as fair or poor health or one of eight chronic health conditions.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64
(n = 61)
(n = 90)
THE COMMONWEALTH
FUND
Percent of Adults Who Have Not Filled a Prescription Due to Cost
2027
2116
3233*26* 2526
0
20
40
60
Total Health Problem** <$50,000 Annual
Income
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
**Health problem defined as fair or poor health or one of eight chronic health conditions.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64
(n = 61)(n = 90)
THE COMMONWEALTH
FUND
Percent of Adults Who Have Skipped Doses to Make a Medication Last Longer
32
20 212015
35*
26* 2829
0
20
40
60
Total Health Problem** <$50,000 Annual
Income
Comprehensive HDHP CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
**Health problem defined as fair or poor health or one of eight chronic health conditions.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64 with prescriptions in last twelve months
(n = 50)(n = 85)
THE COMMONWEALTH
FUND
Availability and Use of Quality and Cost Information Provided by Health Plan
Comprehensive HDHP/CDHPHealth plan provides information on quality of care provided by:
Doctors 14% 16%
Hospitals 14 15
Health plan provides information on cost of care provided by:
Doctors 16 12
Hospitals 15 12
Of those whose plans provide info on quality, how many tried to use it for:
Doctors 42 54
Hospitals 25 45*
Of those whose plans provide info on cost, how many tried to use it for:
Doctors 15 36* (n = 76)
Hospitals 14 32* (n = 76)Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
THE COMMONWEALTH
FUND
Most Trusted Sources for Information on Health Care Providers, by Insurance Source
10
15
20
4342
25
16
8
4
2
6
2
0 20 40 60
Government or other
agency
Own health plan
Medical assoc iation
Family member or friend
Consumer group
Your doctor
Comprehensive
HDHP/CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64
THE COMMONWEALTH
FUND
Percentage of Adults who Agree that Terms of Coverage Make Them Consider Cost When Deciding
to Seek Health Care Services
71*
60*
38
0
20
40
60
80
Comprehensive HDHP CDHPNote: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64 who strongly or somewhat agree
THE COMMONWEALTH
FUND
Cost Conscious Decision-Making, by Insurance Source
27
43
49
19
32*
44*
55*
60*
14
23
0 20 40 60 80
Checked quality rating ofdoctor or hospital
Checked price of service
Asked doctor torecommend less costly
prescription drugs
Talked to doctor abouttreatment options & costs
Checked whether planwould cover care
Comprehensive
HDHP/CDHP
Note: Comprehensive = plan w/ no deductible or <$1000 (ind), <$2000 (fam); HDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), no account; CDHP = plan w/ deductible $1000+ (ind), $2000+ (fam), w/ account.*Difference between HDHP/CDHP and Comprehensive is statistically significant at p ≤ 0.05 or better.
Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005.
Percent of adults 21-64 who received health care in last twelve months
THE COMMONWEALTH
FUND
Conclusion• Low diffusion of consumer-driven plans• Among adults with plans, lower satisfaction with
quality of care, out-of-pocket costs, plan overall; few would recommend plan to friends/co-workers
• High out of pocket costs + premiums amount to substantial share of income, especially among those with lower income and health problems
• No differences in service use, but higher reported rates of cost-related delays, avoidance, or skipping care or Rx, esp. lower income and health problems
• More cost-conscious decision making behavior• Little quality/cost information provided by plans• Consumerism gives disproportionate responsibility
for cost control to those with health problems and low incomes
THE COMMONWEALTH
FUND
Acknowledgements
• Dallas Salisbury, President & CEO, EBRI and EBRI-ERF
• Karen Davis, President, The Commonwealth Fund
• Cathy Schoen, Senior Vice-President, The Commonwealth Fund
• Michelle Doty, Senior Analyst, The Commonwealth Fund
• Jennifer Kriss, Program Assistant, The Commonwealth Fund
Visit EBRI and the Fund at: ebri.org cmwf.org