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Aetna Announces Results of a Six-Year Study of Consumer-Directed Health Plans


Aetna HealthFund® shows sustained savings over time for employers, with members getting the care they need

HARTFORD, Conn. — Aetna (NYSE: AET) today announced the results of a six-year study of health care claims and utilization for members in its Aetna HealthFund® consumer-directed plans. The study of 2.6 million Aetna members (410,000 in an Aetna HealthFund plan) demonstrates that Aetna HealthFund shows sustained savings for employers over a five-year period, with members getting the care they need. The results also show that Aetna HealthFund members are seeking increased levels of chronic and preventive care, using generic drugs more often and accessing online tools and information at higher rates than PPO members, while experiencing lower annualized medical cost increases. Importantly, this year’s results also show that Aetna HealthFund members had lower emergency room use than PPO members, suggesting that members are becoming better informed about where to access health care.

The Aetna HealthFund study included 200 plan sponsors who offered an Aetna HealthFund Health Reimbursement Arrangement (HRA) and/or an Aetna HealthFund Health Savings Account (HSA). The study looked at 2.6 million members across the spectrum of Aetna medical products, including 410,000 Aetna HealthFund members. Key findings include:

For full replacement HRA and HSA plans, employers saved $21 million per 10,000 members over the five year period.
For employers who offer Aetna HealthFund plans as an option, they experienced savings of $7 million per 10,000 members over the five year period.
For employers who offer Aetna HealthFund plans as an option and implemented the strategies that Aetna identified as best-in-class, they achieved savings of $23 million per 10,000 members over the five year period.

“In these difficult economic times, employers are looking for tried and true strategies that will allow them to continue to offer their employees a comprehensive and affordable benefits package,” said Aetna President Mark Bertolini. “As the first national health plan to offer consumer-directed products, Aetna has the longest experience with these plans and the best insight into what strategies are successful.”

Last year, Aetna identified several strategies that have proven successful for employers, including fostering a culture where employees and senior executives are engaged health care consumers, implementing a focused and ongoing employee education campaign, offering wellness programs and incentives for healthy behavior, providing 100 percent coverage for preventive care and carefully constructing a plan with the right mix of member responsibility. While these strategies continue to be successful, Aetna found another approach that can help employers achieve success - encouraging their employees to enroll in the consumer-directed plan option. This can be done by offering the consumer-directed plan option as the lowest cost, lowering the required contribution or increasing the fund amount. Furthermore, this year’s results show that employers who implement these strategies can achieve significant cost savings and that more employers are adopting these strategies and seeing positive results.

“Consumerism in health care is about much more than a product - it is the idea that with the right mix of education, member responsibility and benefits design, you can engage members and help them make more informed health care decisions for themselves and their families. In fact, this year’s results show that consumers in the Aetna HealthFund plans sought online health information twice as often as the control population and were twice as likely to take a health risk assessment,” Bertolini added.

The results also show that Aetna HealthFund members:

Seek preventive care more often than the control matched PPO population. Furthermore, Aetna HealthFund members had 10 percent lower primary care physician utilization for non-routine services and 15 percent lower utilization of specialist care.
Access the same or higher levels of screenings for diabetes and breast and cervical cancer, compared to members in traditional PPO products.
Utilize the prescription drugs necessary to treat chronic conditions such as diabetes, congestive heart failure, coronary artery disease and high cholesterol at similar or higher rates than PPO members.
Use consumer tools and information - including searching for health information, using the cost of care tools available through Aetna Navigator - at twice the rate compared to PPO members.

“Aetna’s analysis of members in its Aetna HealthFund plans exemplifies the importance of providing credible data that will help employers evaluate the performance of these plans. It is always a challenge to adopt new ideas, particularly in the face of a recession,” said Alexander Domaszewicz, Mercer’s Health Consumerism Lead. “The study reinforces the evidence we’ve seen emerge throughout the decade - that strategies such as encouraging employee financial responsibility, offering robust coverage for preventive care and providing a full suite of online tools and information, is helping employers achieve cost savings, promote a healthier workforce and still meet plan sponsor attraction, retention and employee satisfaction goals. We need to recognize, however, that many employees need high touch outreach and face-to-face support when they face complex illnesses. The ideal strategy when implementing consumer-directed health plans combines all of these approaches in the right way.”


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