Analysis from Health Care Service Corporation Shows Consumers Continuously Enrolled in CDHPs Experience Lower Overall Health Care Costs

BlueEdge Account-based Health Plans Grow in Popularity, Encouraging Better Health Care Decision Making and Lower Costs

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Oct 11, 2016, 08:00 ET

CHICAGO, Oct. 11, 2016 /PRNewswire/ -- A comprehensive data analysis¹ conducted by Health Care Service Corporation (HCSC), operator of the Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas, finds that individuals enrolled in consumer-directed health plans (CDHPs) demonstrate health care cost reductions and positive changes in health care usage. The study analyzed health care costs for the first year following migration to a CDHP and continued to monitor those usage patterns for three years after the migration.

The study² tracked more than 400,000 individual Blue Cross and Blue Shield members across HCSC's Plan states and found that in the first year following migration from a PPO plan to a BlueEdge^SM CDHP plan, members experienced an average 7.1³ percent reduction in medical costs. That reduction improved to an average of 9.2 percent in a three-year period⁴^-5.

"Our BlueEdge plans are designed to encourage members to make informed decisions that will help manage costs while maximizing their health care coverage," said Tom Meier, vice president of market solutions, HCSC. "It's about using health care services more wisely without reducing access to care. Our findings demonstrate that members enrolled in consumer-directed health plans are getting the health care services they need, and costs are decreasing. This ideally leads to healthier members who play a more active role in their health care."

After switching from a PPO to HCSC's BlueEdge CDHP, members saw a three-year average reduction in:

Inpatient care costs – decreased by 16.1 percent
Outpatient care costs – decreased by 5.7 percent
Professional services costs – decreased by 10.4 percent

BlueEdge is offered through HCSC's five Blue Cross and Blue Shield Plans and includes Health Savings Account (HSA) and Health Reimbursement Account (HRA) options. BlueEdge enrollment has continued to grow over the last several years, surpassing more than 2 million members across HCSC's five states, with enrollment growing more than 60 percent between 2012 and 2016.

CDHPs, in general, continue to grow in popularity since their adoption as a choice for employers and their employees. According to the 2015 Willis Towers Watson/National Business Group on Health (NBGH) Best Practices in Health Care Survey⁶, 82 percent of companies had an account-based health plan (ABHP) in 2015, and another 4 percent expected to add one for the first time in 2016. Looking ahead, the study anticipates that 50 percent of all companies could offer an ABHP as their only plan option by 2018.

BlueEdge members choose providers from large PPO networks across the United States. Close to 92 percent of independently contracted doctors and 96 percent of independently contracted hospitals nationally participate in this network. In addition, HCSC's BlueEdge members have access to interactive decision-support tools⁷ that help them toward effective spending and benefit planning, including:

Provider Finder^®: an online tool that helps members locate doctors, dentists, pharmacies and other health care providers in their network, as well as compare costs for certain medical procedures, treatments and tests;
Blue Care Connection^®: a care management program for chronic conditions and lifestyle management programs for smoking cessation, Metabolic Syndrome and weight management;
Benefit Value Advisor^®: a one-call, transparency solution that provides members with a specially trained advisor that can help them with provider-specific cost and quality information for common procedures; clinical educational support; pre-authorization coordination and appointment scheduling.

About Health Care Service Corporation
Health Care Service Corporation is the country's largest customer-owned health insurer and fourth largest health insurer overall, with more than 15 million members in its Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross and Blue Shield Association. HCSC has a rating of A+ (Strong) from Standard and Poor's, A1 (Good) from Moody's and A (Excellent) from A.M. Best Company. For more information, please visit HCSC.com, visit our Facebook page or follow us at twitter.com/HCSC.

¹ Internal claims data from 2010 – 2014.
² Savings data was validated by Truven.
³ All stats represented as per member per month; risk and trend adjusted.
⁴ Three-year averages include up to three years of continuous CDHP claims experience, where available
⁵ One-year average per member per year savings dollars are $280.06 for medical only. The three-year average per member per year savings dollars are $362.96 for medical only.
⁶ 2015 20th Annual Towers Watson/National Business Group on Health Best Practices in Health Care Employer Survey. https://www.towerswatson.com/en-US/Insights/IC-Types/Survey-Research-Results/2015/11/full-report-2015-towers-watson-nbgh-best-practices-in-health-care-employer-survey ⁷ Availability based on member plan design.