CDHPs may be, as the title of Contributing Editor MargaretAnn Cross's cover story suggests, turning the corner in the real world, but they've been with us a long time in publishing. After years of expectation and debate, consumer-directed health plans are all over the place in real life as well as this issue of Managed Care.
You couldn't call this a theme issue, exactly. We talk about limited-coverage plans and challenges in constructing acceptable pay-for-performance programs. So consumer-directed coverage is now just another part of the mix.
And yet, CDHPs take up more and more of our coverage. We're beginning to get the feeling that this may be more than a theme.
I'm not saying that you should expect a magazine called "CDHP" soon, at least not from us (from where we sit, CDH in its current state of development is definitely a variation on the managed care theme) — only that CDHPs have reached the end of the beginning.
But what a beginning.
Large employers push for this and large health plans respond. Insurers' first steps are often to test CDHPs on their own employees. The system so far has passed with flying colors, but there are many issues to be worked out, with potentially serious consequences for patients in some scenarios. Providers will also have to adjust, though the issues may be different for doctors compared with, say, hospitals.
It's up to the various stakeholders, and there are very many, to make consumer-directed care work for all of us; if they fail, yet another new paradigm will come down the pike to take its place. Without doubt, we are in for another exciting ride, toward utopia or, perhaps, a brave new world.