Education is Essential in Switching to New Plans

Sunday, October 14, 2007
JOE ROJAS-BURKE
The Oregonian Staff

For years, David Evans and Associates Inc., an environmental and engineering firm in Portland, offered a fairly typical health plan to more than 1,000 employees across several states. But after relentless cost increases, "we realized we had to come up with more comprehensive solutions," said Michelle Willis, associate director of human resources.

In January, the firm offered employees the choice of a high-deductible plan with a health-savings account. To promote enrollment, the company deposited up to $1,250 in the employee's savings account -- a sum equal to half the deductible for family coverage. The company also paid 100 percent of the premium for dependents in the high-deductible option, compared with 90 percent of the premium for the company's standard insurance plan. About a fifth of the work force signed up for the new option, Willis said.

The most important lesson after one year, she said, is realizing that educating and supporting employees is paramount. "Introducing a plan with a completely new design takes a lot of education," Willis said. "It's not going to be a one-time education endeavor. It's going to be ongoing."

Among the 170 million people covered by employer-sponsored health insurance nationwide, fewer than 6 million are enrolled in a consumer-directed health plan. But the coverage is growing fast. The percentage of employers offering consumer-directed plans tripled from 2005 to 2006, rising from 2 percent to 6 percent, according to a survey by Mercer Health & Benefits conducted last year. About 16 percent of employers said they were "very likely" to add such a plan by 2008, compared with 1 percent of employers two years earlier.

The trend disturbs some consumer advocates and labor unions. They say consumers are being thrust into a no-win situation, lacking realistic information about quality and price -- and the market clout to bargain effectively with the likes of hospital corporations and drug companies.

"Choosing your health care is not like going out and buying a video camera," said Shauna Ballo with the Service Employees International Union Local 49. "We don't have access to enough information about which hospitals cost more, are more efficient and have better outcomes."