The shift to health care consumerism is well underway. Trendscontinue to point to increased financial responsibility for consumerswith rising deductibles, increased consumer out-of-pocketresponsibilities, and accelerated adoption of consumer directedhealth care plans (CDHPs), health savings accounts(HSAs), and other account-based benefitofferings.

According to Mercer, enrollment in CDHPs among largeemployers nearly doubled in the past three years from 15 percent to28 percent of covered employees.

Employer adoption of these consumer-directed benefit designswill continue to grow for the foreseeable future, driven by theneed for cost control, the impact of health care reform and thelooming excise tax. The costs of providing health care continue torise, surpassing $25,000 for an average family for the first timein 2016 (Milliman Medical Index).

However, the fact that the term “consumer directed health care(CDH)” has become almost synonymous with CDHPs and HSAs is a bit ofa misnomer. In reality, CDH is much more than a benefit design – itis a paradigm shift for how consumers must manage their health careand make health care decisions going forward.

Dimensions of consumer-directed health care

The underlying premise of CDH is that, if given more financialresponsibility for health care and empowered to make informeddecisions, consumers will make better choices – leading to improvedhealth outcomes and decreased overall health care costs. Implicitin this definition are two equally important dimensions:

1. Benefit designs that require increased consumer financialaccountability

2. Empowerment and engagement to support decision-making

The market has made considerable progress shifting to benefitmodels that increase consumer financial responsibility, asevidenced by the data above. While new plan designs have beencreated and successfully implemented, financial accountability isonly the beginning— behavior must change too, not just costs. Wehave only just begun to unlock the second dimension of health careconsumerism.

Giving somebody new responsibility without the education, toolsand support to manage those responsibilities is like giving ateenager the keys to the car without teaching them todrive.

Unlocking consumer engagement

So where does the health care industry really stand in terms ofengaging and empowering consumers to make better choices? Thehealth care industry is still struggling to drive meaningfulconsumer engagement.

Consumer fluency is low. Alegeus research is clear thatconsumers still don’t have a good grasp on how the plans work, howto predict and manage out of pocket costs, how to determinecoverage, etc. Engagement overall is low. The averageconsumer interacts with their health plan just one or two times peryear – and more than 40 percent of members have never taken thetime to log-on, dial-in, subscribe, or download any content fromtheir benefit providers.

And in many cases, consumers are resistant to change. When askedwhether they wanted to take a more active role in managing theirhealth care, 50 percent said no thanks.

Employers are now spending nearly $700 per employee on variousemployee engagement programs related to health care, per Fidelity.There are more tools and resources than ever before. Yet most ofthese programs are delivered with a “one-size-fits-all” approach,and the consumer experience is still very fragmented.

However, by its very nature, CDH may be the key to unlockingconsumer engagement. CDHP members are significantly more engagedthan their counterparts in traditional coverage for one veryimportant reason…

People pay attention to their money

According to our research, people enrolled in CDHPs scoreduniversally higher on all measures of engagement. CDHPmembers:

• Are considerably more fluent in the details of health carecoverage, costs and billing

• Are more value-conscious - 50 percent more likely to researchand compare costs for health care purchases

• Interact more frequently– the average CDHP member interacts withtheir account 10-50 times per year

• Leverage available resources & channels - one third morelikely to consume content and engage with their benefit serviceproviders through available channels

• Are more likely to participate - twice as likely to participatein employer engagement and wellness programs

Although CDHP members interact more frequently, the key to trueengagement and behavior change is not justdriving more interactions, it isdriving strategic engagement that is targeted, timely andrelevant.

Health & wealth must converge

The path to true, meaningful engagement in health care may liein the convergence of these financial components with thetraditional health care domain. No matter what age, healthstatus, or consumer segment, the responsibility for managingfinances and costs will become universal.

The convergence of claims, financial transactions and otherbehavioral and demographic data will provide a robust foundationfor targeted engagement.

The fact that consumers pay closer attention to their financespresents a unique opportunity to tap into a captive audience withpersonalized offers, messages and value-added tools designed toimprove engagement, influence behavior and enhancedecision-making.

For the vision of consumer directed health care to be fullyrealized, it is imperative that employers and benefit providers donot overlook the critical importance of education and targetedengagement to empower better decision making – and better outcomesfor all stakeholders.