Consumer driven health care
Encyclopedia
Defined narrowly, consumer-driven health care (CDHC) refers to third tier health insurance plans that allow members to use personal health savings account
s (HSAs), Health Reimbursement Account
s (HRAs), or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance
policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances, or to invest for future expenses.
This system of health care is referred to as "consumer driven health care" because routine claims are paid using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. According to economist John C. Goodman, "In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive." Goodman points to a McKinsey study which found that CDHC patients were twice as likely as patients in traditional plans to ask about cost and three times as likely to choose a less expensive treatment option, and chronic patients were 20 percent more likely to follow treatment regimes carefully.
Consumer driven health care received a boost in the U.S. in 2003, with passage of federal legislation providing tax incentives to those who choose such plans. Proponents argue that most Americans will pay less for health care in the long haul under CDHC not only because their monthly premiums will be lower, but also because the use of HSAs and similar products increases free-market variables in the health care system, fostering competition, which in turn lowers prices and stimulates improvements in service.
Critics argue that CDHC will cause consumers, particularly those less wealthy and educated, to avoid needed and appropriate health care because of the cost burden and the inability to make informed, appropriate choices. "Consumer-driven health care is badly named, because it's certainly not driven by consumers," said Jonathan Oberlander, political scientist, University of North Carolina, Chapel Hill. It's "really just shifting the cost of health care onto the backs of the patients." People with chronic illnesses, such as diabetes, will be hurt, because with a deductible of $3,000 to $4,000, such people will never be able to save anything in their savings accounts. "Employers like it because they're going to save money," but they're not going to fund these health care accounts adequately, he said. "Conservatives tend to support consumer-driven health care. They believe, as do a fair number of health economists, that people use too much health care, and use too much health care of little value. If you move to high-deductible plans, people will think twice. If I have a sore throat, instead of going to my physician, I'll have a cup of tea instead."
HSAs are seen by proponents as a way to make health care more affordable and accessible in the U.S. The Medicare Prescription Drug, Improvement, and Modernization Act
, which included provisions designed to stimulate the popularity of these plans, was passed by Congress
in November 2003 and signed into law by President Bush in December 2003. The law expanded medical savings accounts, renaming them Health Savings Accounts and created tax incentives to encourage adoption of high-deductible health plans. Banks were empowered to create HSAs, which deliver tax-free interest to the holders, who can then withdraw money tax free to pay for qualified health care expenditures. To qualify for an HSA, the purchaser must also have a qualifying high-deductible health insurance plan. Over time, participants are allowed to contribute more (cumulatively) to the savings account than would be required to fulfill their annual deductible
for a given year (although annual limits on pre-tax contributions [other than a 1-time IRA rollover option] are well below the annual deductible), and any unused portions of the account accrue without tax
penalty so long as the funds are used only for qualified medical expenses.
Further enhancements to HSAs went into effect in 2007. The combination of tax breaks for premiums and the health savings account as well as a tax subsidy to pay for the catastrophic insurance
premium of lower income individuals has boosted the popularity of these plans. By April 2007, some 4.5 million Americans were enrolled in HSAs; more than a fourth of those were previously uninsured.
Another model of consumer driven health care is Health Reimbursement Arrangements (HRAs), which are employer-funded, and in which employers receive the tax benefits.
By 2007, an estimated 3.8 million U.S. workers, about 5 percent of the covered workforce, were enrolled in consumer-driven plans. About 10 percent of firms offered such plans to their workers, according to a study by the Kaiser Family Foundation
. In August 2008 the Atlanta Business Chronicle reported that enrollment in consumer-driven plans was increasing, accounting for 13% of all plans offered by employers.
Other countries with experience in this type of health insurance include China
, Taiwan
, Singapore
and South Africa
.
at the University of Minnesota
(Stephen T. Parente), Harvard University
(Meredith Rosenthal), University of Illinois at Chicago
(Anthony LoSasso) and RAND Health Insurance Experiment
have examined results of these plans. Health insurers, Aetna
, Wellpoint
, Humana
and UnitedHealth Group
have all provided their own independent analyses as well.
In general, most studies, starting with the RAND study, conclude that increasing the costs (co-payments and deductibles) of health care to the patient reduces the consumption of health care, but it reduces the consumption of both appropriate and inappropriate care, and the reduction is greater for low-income patients. For example, Joseph Newhouse
, in summarizing the RAND study, reported that visits to doctors and hospitals decline with higher cost sharing, "although for low income families such cutbacks reduced their use of beneficial as well as unnecessary services and was estimated to have increased rates of death from preventable illness." However, proponents counter these findings with studies indicating that CDHCs have broad appeal, provide a new option for the uninsured, and are leading to new incentives for people to be more engaged in managing their health. One study found that the levels and trends of use of preventive and screening services by enrollees in consumer-directed health plans (CDHPs) was similar to that of enrollees in Preferred provider organization
(PPO) plans. The authors concluded that "[p]eople enrolled in CDHPs such as those we studied do not underuse preventive services to any greater degree than do those in traditional PPOs."
The Kaiser Family Foundation studied how consumer-driven health plans cover pregnancy. They found wide variations in cost sharing. Pregnant women could face exposure to high out-of-pocket costs under consumer-driven health plans, particularly when complications arise. In one scenario, a complicated pregnancy, with gestational diabetes, pre-term labor, cesarian section and neonatal intensive care, would cost $287,000. Under some consumer-directed health plans, the cost to the family would be $6,000, less than some traditional policies. But under other consumer-directed health plans, the cost to the family would be as high as $21,000.
. "Despite the theory (as expressed in the Economic Report of the President) that health insurance with higher deductibles will lead to consumers shopping around for health services (based on price and quality), the reality of...inadequate information in the marketplace about health care quality and prices precludes the workability of a 'consumer-choice' type of model," Gail Shearer, director of health policy analysis for Consumers Union, told the Joint Economic Committee of the U.S. Congress in February 2004.
Jessie Gruman
, who interviewed 200 patients and families about how they used scientific information after devastating medical diagnoses, said, "I fear that the trend toward consumer-driven health care will disproportionately damage the health of the less educated and less wealthy, and that the net effect on the nation's health has already proved negative." She concluded that most patients are unable to make critical decisions about their health care in the consumer-driven model. But Some people, called "monitors," track down detailed information, while other people, called "blunters," don't want information. One blunter, a theoretical physicist, said he would be "insulted" if someone read 15 papers on theoretical physics and asked him to help design an experiment; he pays his doctor to explain his choices. A "monitor," a lawyer, applied her legal research skills but couldn't think clearly enough to decide. People turn to the Internet, become overwhelmed, or don't understand the significance of the information. "Most health information is bad news," is stressful, and makes decisions even more difficult.
According to Robert Reischauer, president of the Urban Institute and vice chairman of the Medicare Payment Advisory Commission, "Accessible information on the quality, price, effectiveness and efficiency of health-care services and providers is developing rapidly, but is nowhere near the minimum standard assumed by well functioning CDHC. And employers, bound in part by Treasury Department regulations, do not vary deductibles, catastrophic caps or contributions to HSAs and HRAs to workers' family incomes or health status as equitable CDHC would call for....Many things we buy in health care are pieces of larger packages which are undefined when the decisions are made concerning whether to purchase and where to purchase. For example, when one goes to the doctor because of a particular set of symptoms, the doctor ask a number of questions which leads to a series of recommended tests whose results then determine an appropriate treatment regime. One could select the doctor to visit on the basis of price and quality but that is no guarantee that the package of tests and treatments that resulted would be the lowest cost or highest quality....The costs of the really expensive treatments would be largely unaffected."
But proponents of CDHC, such as former House Speaker Newt Gingrich
, have pointed to the rise of the Internet and online comparative shopping health services as one reason they believe the CDHC model is viable. In 2006, several technology firms, such as Vimo
, HealthSouk and My Health Direct, emerged to take advantage of what they believe will be a new market for comparative health care shopping with the rise of CDHC plans and with the goal of leveraging the Internet to increase price transparency in the health care market.
Association found widespread satisfaction among HSA customers, a survey published in 2007 by employee benefits consultants Towers Perrin came to the opposite conclusion; it found that employees currently enrolled in such plans were significantly less satisfied with many elements of the health benefit plan compared to those enrolled in traditional health benefit plans.
Some policy analysts say that consumer satisfaction doesn't reflect quality of health care. Researchers at Rand Corp. and Department of Veterans Affairs asked 236 elderly patients at 2 managed care plans to rate their care, then examined care in medical records, as reported in Annals of Internal Medicine. There was no correlation. "Patient ratings of health care are easy to obtain and report, but do not accurately measure the technical quality of medical care," said John T. Chang, UCLA, lead author.
Health savings account
A health savings account is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan . The funds contributed to an account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account...
s (HSAs), Health Reimbursement Account
Health Reimbursement Account
Health Reimbursement Accounts or Health Reimbursement Arrangements are Internal Revenue Service -sanctioned programs that allow an employer to set aside funds to reimburse medical expenses paid by participating employees...
s (HRAs), or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances, or to invest for future expenses.
This system of health care is referred to as "consumer driven health care" because routine claims are paid using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. According to economist John C. Goodman, "In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive." Goodman points to a McKinsey study which found that CDHC patients were twice as likely as patients in traditional plans to ask about cost and three times as likely to choose a less expensive treatment option, and chronic patients were 20 percent more likely to follow treatment regimes carefully.
Consumer driven health care received a boost in the U.S. in 2003, with passage of federal legislation providing tax incentives to those who choose such plans. Proponents argue that most Americans will pay less for health care in the long haul under CDHC not only because their monthly premiums will be lower, but also because the use of HSAs and similar products increases free-market variables in the health care system, fostering competition, which in turn lowers prices and stimulates improvements in service.
Critics argue that CDHC will cause consumers, particularly those less wealthy and educated, to avoid needed and appropriate health care because of the cost burden and the inability to make informed, appropriate choices. "Consumer-driven health care is badly named, because it's certainly not driven by consumers," said Jonathan Oberlander, political scientist, University of North Carolina, Chapel Hill. It's "really just shifting the cost of health care onto the backs of the patients." People with chronic illnesses, such as diabetes, will be hurt, because with a deductible of $3,000 to $4,000, such people will never be able to save anything in their savings accounts. "Employers like it because they're going to save money," but they're not going to fund these health care accounts adequately, he said. "Conservatives tend to support consumer-driven health care. They believe, as do a fair number of health economists, that people use too much health care, and use too much health care of little value. If you move to high-deductible plans, people will think twice. If I have a sore throat, instead of going to my physician, I'll have a cup of tea instead."
Background
Consumer driven health care plans had their origin in the U.S. in the late 1990s. It was developed as a business model for health ventures. They were designed to engage consumers more directly in their health care purchases. The initial conceptual model made cost and quality information available to the consumer, usually through the Internet.HSAs are seen by proponents as a way to make health care more affordable and accessible in the U.S. The Medicare Prescription Drug, Improvement, and Modernization Act
Medicare Prescription Drug, Improvement, and Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...
, which included provisions designed to stimulate the popularity of these plans, was passed by Congress
United States Congress
The United States Congress is the bicameral legislature of the federal government of the United States, consisting of the Senate and the House of Representatives. The Congress meets in the United States Capitol in Washington, D.C....
in November 2003 and signed into law by President Bush in December 2003. The law expanded medical savings accounts, renaming them Health Savings Accounts and created tax incentives to encourage adoption of high-deductible health plans. Banks were empowered to create HSAs, which deliver tax-free interest to the holders, who can then withdraw money tax free to pay for qualified health care expenditures. To qualify for an HSA, the purchaser must also have a qualifying high-deductible health insurance plan. Over time, participants are allowed to contribute more (cumulatively) to the savings account than would be required to fulfill their annual deductible
Deductible
In an insurance policy, the deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses. It is normally quoted as a fixed quantity and is a part of most policies covering losses to the policy holder. The deductible must be paid by the insured,...
for a given year (although annual limits on pre-tax contributions [other than a 1-time IRA rollover option] are well below the annual deductible), and any unused portions of the account accrue without tax
Tax
To tax is to impose a financial charge or other levy upon a taxpayer by a state or the functional equivalent of a state such that failure to pay is punishable by law. Taxes are also imposed by many subnational entities...
penalty so long as the funds are used only for qualified medical expenses.
Further enhancements to HSAs went into effect in 2007. The combination of tax breaks for premiums and the health savings account as well as a tax subsidy to pay for the catastrophic insurance
Insurance
In law and economics, insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment. An insurer is a company selling the...
premium of lower income individuals has boosted the popularity of these plans. By April 2007, some 4.5 million Americans were enrolled in HSAs; more than a fourth of those were previously uninsured.
Another model of consumer driven health care is Health Reimbursement Arrangements (HRAs), which are employer-funded, and in which employers receive the tax benefits.
By 2007, an estimated 3.8 million U.S. workers, about 5 percent of the covered workforce, were enrolled in consumer-driven plans. About 10 percent of firms offered such plans to their workers, according to a study by the Kaiser Family Foundation
Kaiser Family Foundation
The Henry J. Kaiser Family Foundation , or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. It focuses on the major health care issues facing the nation, as well as the U.S. role in global health policy...
. In August 2008 the Atlanta Business Chronicle reported that enrollment in consumer-driven plans was increasing, accounting for 13% of all plans offered by employers.
Other countries with experience in this type of health insurance include China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
, Taiwan
Taiwan
Taiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...
, Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...
and South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
.
Research on impacts
Researchers at the Carlson School of ManagementCarlson School of Management
The school offers a bachelor's, MBA, and doctoral degrees, as well as executive education programs hosted domestically and abroad . Dual-degree programs include a JD/MBA, MD/MBA, MHA/MBA, and a MPP/MBA...
at the University of Minnesota
University of Minnesota
The University of Minnesota, Twin Cities is a public research university located in Minneapolis and St. Paul, Minnesota, United States. It is the oldest and largest part of the University of Minnesota system and has the fourth-largest main campus student body in the United States, with 52,557...
(Stephen T. Parente), Harvard University
Harvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...
(Meredith Rosenthal), University of Illinois at Chicago
University of Illinois at Chicago
The University of Illinois at Chicago, or UIC, is a state-funded public research university located in Chicago, Illinois, United States. Its campus is in the Near West Side community area, near the Chicago Loop...
(Anthony LoSasso) and RAND Health Insurance Experiment
RAND Health Insurance Experiment
The RAND Health Insurance Experiment was an experimental study of health care costs, utilization and outcomes in the United States, which assigned people randomly to different kinds of plans and followed their behavior, from 1974 to 1982. As a result, it provided stronger evidence than studies...
have examined results of these plans. Health insurers, Aetna
Aetna
Aetna, Inc. is an American health insurance company, providing a range of traditional and consumer directed health care insurance products and related services, including medical, pharmaceutical, dental, behavioral health, group life, long-term care, and disability plans, and medical management...
, Wellpoint
WellPoint
WellPoint, Inc. is the largest health plan company in the Blue Cross and Blue Shield Association. It was formed when WellPoint Health Networks, Inc. merged into Anthem, Inc., with the surviving Anthem adopting the name, WellPoint, Inc...
, Humana
Humana
Humana Inc. , founded in 1961 in Louisville, Kentucky, is a Fortune 100 company that markets and administers health insurance. With a customer base of over 11.5 million in the United States, the company is the largest Fortune 100 company headquartered in the Commonwealth of Kentucky, and has a...
and UnitedHealth Group
UnitedHealth Group
UnitedHealth Group Incorporated is a diversified health and "well-being" company. Headquartered in Minnetonka, Minnesota, UnitedHealth Group offers a spectrum of products and services through two operating businesses: United Healthcare and Optum. Through its family of subsidiaries and divisions,...
have all provided their own independent analyses as well.
In general, most studies, starting with the RAND study, conclude that increasing the costs (co-payments and deductibles) of health care to the patient reduces the consumption of health care, but it reduces the consumption of both appropriate and inappropriate care, and the reduction is greater for low-income patients. For example, Joseph Newhouse
Joseph Newhouse
Joseph P. Newhouse is an American economist and the John D. MacArthur Professor of Health Policy and Management at Harvard University, as well as the Director of the Division of Health Policy Research and of the Interfaculty Initiative on Health Policy...
, in summarizing the RAND study, reported that visits to doctors and hospitals decline with higher cost sharing, "although for low income families such cutbacks reduced their use of beneficial as well as unnecessary services and was estimated to have increased rates of death from preventable illness." However, proponents counter these findings with studies indicating that CDHCs have broad appeal, provide a new option for the uninsured, and are leading to new incentives for people to be more engaged in managing their health. One study found that the levels and trends of use of preventive and screening services by enrollees in consumer-directed health plans (CDHPs) was similar to that of enrollees in Preferred provider organization
Preferred provider organization
In health insurance in the United States, a preferred provider organization is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced...
(PPO) plans. The authors concluded that "[p]eople enrolled in CDHPs such as those we studied do not underuse preventive services to any greater degree than do those in traditional PPOs."
The Kaiser Family Foundation studied how consumer-driven health plans cover pregnancy. They found wide variations in cost sharing. Pregnant women could face exposure to high out-of-pocket costs under consumer-driven health plans, particularly when complications arise. In one scenario, a complicated pregnancy, with gestational diabetes, pre-term labor, cesarian section and neonatal intensive care, would cost $287,000. Under some consumer-directed health plans, the cost to the family would be $6,000, less than some traditional policies. But under other consumer-directed health plans, the cost to the family would be as high as $21,000.
Information needs and providers
Key to CDHC's success is ready access of plan users to information about health products, services, and pricing. Critics of CDHC argue that the system will only saddle consumers with more expenses because free-market variables can never exist in health care due to lack of pricing transparencyTransparency (market)
In economics, a market is transparent if much is known by many about:* What products, services or capital assets are available.* What price.* Where....
. "Despite the theory (as expressed in the Economic Report of the President) that health insurance with higher deductibles will lead to consumers shopping around for health services (based on price and quality), the reality of...inadequate information in the marketplace about health care quality and prices precludes the workability of a 'consumer-choice' type of model," Gail Shearer, director of health policy analysis for Consumers Union, told the Joint Economic Committee of the U.S. Congress in February 2004.
Jessie Gruman
Jessie Gruman
Jessie Gruman is active in the movement to incorporate evidence into health care and to help consumers adopt healthier behaviors. Gruman is the founder and president of the Washington-based Center for Advancing Health. She is the author of AfterShock: What to Do When the Doctor Gives You -- or...
, who interviewed 200 patients and families about how they used scientific information after devastating medical diagnoses, said, "I fear that the trend toward consumer-driven health care will disproportionately damage the health of the less educated and less wealthy, and that the net effect on the nation's health has already proved negative." She concluded that most patients are unable to make critical decisions about their health care in the consumer-driven model. But Some people, called "monitors," track down detailed information, while other people, called "blunters," don't want information. One blunter, a theoretical physicist, said he would be "insulted" if someone read 15 papers on theoretical physics and asked him to help design an experiment; he pays his doctor to explain his choices. A "monitor," a lawyer, applied her legal research skills but couldn't think clearly enough to decide. People turn to the Internet, become overwhelmed, or don't understand the significance of the information. "Most health information is bad news," is stressful, and makes decisions even more difficult.
According to Robert Reischauer, president of the Urban Institute and vice chairman of the Medicare Payment Advisory Commission, "Accessible information on the quality, price, effectiveness and efficiency of health-care services and providers is developing rapidly, but is nowhere near the minimum standard assumed by well functioning CDHC. And employers, bound in part by Treasury Department regulations, do not vary deductibles, catastrophic caps or contributions to HSAs and HRAs to workers' family incomes or health status as equitable CDHC would call for....Many things we buy in health care are pieces of larger packages which are undefined when the decisions are made concerning whether to purchase and where to purchase. For example, when one goes to the doctor because of a particular set of symptoms, the doctor ask a number of questions which leads to a series of recommended tests whose results then determine an appropriate treatment regime. One could select the doctor to visit on the basis of price and quality but that is no guarantee that the package of tests and treatments that resulted would be the lowest cost or highest quality....The costs of the really expensive treatments would be largely unaffected."
But proponents of CDHC, such as former House Speaker Newt Gingrich
Newt Gingrich
Newton Leroy "Newt" Gingrich is a U.S. Republican Party politician who served as the House Minority Whip from 1989 to 1995 and as the 58th Speaker of the U.S. House of Representatives from 1995 to 1999....
, have pointed to the rise of the Internet and online comparative shopping health services as one reason they believe the CDHC model is viable. In 2006, several technology firms, such as Vimo
Vimo
Vimo Inc. is a comparison-shopping portal for healthcare products and services. On January 24, 2006, the company launched a website to allow businesses and consumers to research, rate and purchase health insurance plans and Health Savings Accounts , and rate US doctors...
, HealthSouk and My Health Direct, emerged to take advantage of what they believe will be a new market for comparative health care shopping with the rise of CDHC plans and with the goal of leveraging the Internet to increase price transparency in the health care market.
Consumer satisfaction
Consumer satisfaction results have been mixed. While a 2005 survey by the Blue Cross and Blue ShieldBlue Shield
Blue Shield may refer to:*Blue Cross and Blue Shield Association*International Committee of the Blue Shield*Blue Shield , a Marvel Comics Superhero...
Association found widespread satisfaction among HSA customers, a survey published in 2007 by employee benefits consultants Towers Perrin came to the opposite conclusion; it found that employees currently enrolled in such plans were significantly less satisfied with many elements of the health benefit plan compared to those enrolled in traditional health benefit plans.
Some policy analysts say that consumer satisfaction doesn't reflect quality of health care. Researchers at Rand Corp. and Department of Veterans Affairs asked 236 elderly patients at 2 managed care plans to rate their care, then examined care in medical records, as reported in Annals of Internal Medicine. There was no correlation. "Patient ratings of health care are easy to obtain and report, but do not accurately measure the technical quality of medical care," said John T. Chang, UCLA, lead author.
See also
- Flexible spending accountFlexible spending accountA flexible spending account , also known as a flexible spending arrangement, is one of a number of tax-advantaged financial accounts that can be set up through a cafeteria plan of an employer in the United States...
- Health care systems
- Health insuranceHealth insuranceHealth insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
- Health insurance in the United StatesHealth insurance in the United StatesThe term health insurance is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government...
- Health reimbursement arrangement
- Health savings accountHealth savings accountA health savings account is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan . The funds contributed to an account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account...
- Medical savings accountMedical savings accountMedical savings account refers to an account in which tax-deferred deposits can be made for medical expenses.-In Singapore:Medisave was introduced in April 1984 as a national medical savings system for Singaporeans...
- Health economicsHealth economicsHealth economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and health care...
- Consumers for health care choicesConsumers for health care choicesConsumers for health care choices is a non-profit advocacy group for consumer driven health careIn 2008 it gave the following awards recognizing pioneers in health care:...
External links
- U.S. Treasury Site on HSAs
- "The Impact of Consumer- Driven Health Plans on Health Care Costs: A Closer Look at Plans with Health Reimbursement Accounts," Public Policy Monograph, American Academy of ActuariesAmerican Academy of ActuariesThe American Academy of Actuaries, also known as the “Academy” or the AAA, is the body that represents and unites United States actuaries in all practice areas...
, January 2004 http://www.actuary.org/pdf/health/cdhp_jan04.pdf - CDHC Solutions Online --The Latest News Surrounding Consumer-driven Health Care