Janice Frates, PhD
Health Care Administration Program, California State University–Long Beach
Ellen Severoni, RN
California Health Decisions, Orange, Calif.

As CDHPs increasingly penetrate the commercial market , their greatest contribution might lie in funding health services for retirees and in reducing the number of uninsured people by offering affordable insurance.

Janice Frates, PhD

Health Care Administration Program, California State University–Long Beach

Ellen Severoni, RN

California Health Decisions, Orange, Calif.


Purpose. Consumer-directed health plans (CDHPs) are a new health insurance product that is of growing interest to employers who are struggling to cope with rising health insurance premium costs and to consumers who are desiring more choice and engagement in their health care. This paper presents the results of a study of California consumer awareness of, and attitudes toward, CDHPs in the context of several national surveys and the experiences of some early-adopting employers.

Design and methodology. California Health Decisions conducted a telephone survey of 800 insured adult California residents in November 2002.

Principal findings. Few respondents had heard of CDHPs. They appealed more to younger, single, less educated, and healthier respondents and those who did not understand them well. The most attractive CDHP features were greater provider choice and health savings accounts' portability and flexibility. Concerns centered on personal financial exposure.

Conclusion. While CDHPs' commercial market penetration is increasing, their greatest potential future contributions might be to reduce the number of uninsured Americans by offering an affordable health insurance product and to fund additional health services for retirees. As CDHPs further evolve, more consumer involvement in their refinement, implementation, and evaluation is essential.

Funding for this research was provided by California Health Decisions, which describes itself as "a non-profit consumer advocacy and consulting organization dedicated to putting consumer values at the heart of the health care system." «http:/www/cahd.org»

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