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Impact of Consumer-Directed Health Plans
September 2016
Consumer-directed health plans are one of the fastest-growing benefit options for U.S. employees. A CDHP is a high-deductible preferred provider organization that is combined with either a health reimbursement arrangement or health savings account. Fund contributions are made by plan members or sponsors annually; unused amounts are typically carried over to the next plan year. Participants are encouraged to use decision-support tools to make more informed healthcare decisions and efficiently manage their fund. Truven Health Analytics conducted a study to provide employer and health plan decision-makers, and others in the healthcare industry, with key insights on the effectiveness of CDHPs in terms of multiyear cost, care, and utilization changes.
The Truven Health Analytics™ 15 Top Health Systems study identifies U.S. health system leadership teams that have most effectively aligned outstanding performance across their organizations, and achieved more reliable outcomes in every member hospital. The study measures relative balanced performance across a range of organizational key performance indicators including care quality, use of evidence-based medicine, postdischarge outcomes, operational efficiency, and patient perception of care. Just as evidence-based medicine is key to exceptional patient care, evidenced-based management is key to the well-being and success of health systems.
The changing healthcare environment has put pressure on healthcare organizations to deliver top-quality care while keeping costs under control. Superior operational and financial performance can be measured by high margins and low costs. But there are significant operational indicators that differ between high- and low-performing hospitals, depending on whether performance is defined by expense or by margin. Often, hospitals with the lowest costs are considered the most successful. But low-cost hospitals do not necessarily behave the same way as hospitals with healthy margins. Low-cost hospitals can include both efficient hospitals and hospitals that are in dire financial circumstances that have forced them to even eliminate expenses necessary for their long-term fiscal health.
The shift from inpatient to outpatient care is increasing as hospitals transition from volume to value. A specific shift is seen in interventional cardiology treatment (cardiac catheterization, intracoronary stents, and percutaneous transluminal coronary angioplasties [PTCA]), which is moving from an inpatient hospital to outpatient hospital setting. Preliminary data show that most interventional cardiology procedures will soon be performed in the hospital outpatient setting. It will be important for hospitals to consider future demand and volume for interventional cardiology services; capacity for an increase in hospital outpatient volume; and staffing and operational implications.
