Can physicians make CDHPs work?

Over the past few years, the healthcare industry has experimented earnestly with so-called consumer-driven health plans. The plans, which had the strong backing of the Bush Administration, have become considerably more popular with employers--and form the basis of health reform in Massachusetts.

The thing is, there still seems to be little reasoned discussion as to whether it makes sense to give consumers complete control of fist-dollar spending. And that's a shame, since there's a growing body of academic evidence suggesting that consumers aren't ready to take a controlling role. For example, a study funded by the Robert Wood Johnson Foundation concluded that when consumers are put into CDHPs, they don't cut back on wasteful services, but instead cut back randomly, particularly if they're poor and undereducated. If that's true, how can they improve the cost-effectiveness of care?

But there may be another answer. Some critics have suggested that CDHPs may work if providers--especially physicians--get engaged in the CDHP model, as they're in a position to advise consumers in a far more effective way than websites or guidebooks ever could. A physician-driven, consumer-engaged model is probably the best chance for making CDHPs work. (This assumes that consumers will be able to fund their HSAs, but that's another story.)

To date, physicians haven't gotten on board. In fact, a recent study suggests that few physicians understand health savings accounts and CDHPs, are in no position to advise patients about the cost of procedures outside of their practice, and seldom familiarize themselves with standardized quality information on hospitals and other physicians.

As healthcare financial managers, you may have a role to play here. You may be in a position to share information on CDHPs with your physicians (especially salaried physicians completely allied with your organization) and help them become the kind of advisors consumers with CDHPs need.

If you take the trouble to get physicians involved with guiding consumers through the CDHP model, not only will consumers be happier, you may end up with fewer unpaid bills. After all, consumers who get the right guidance are far more likely to spend wisely, which may very well lower their expenses.

What do you think, readers? Can the CDHP model work if physicians and consumers work together--and is it worth the trouble to work on building this team? - Anne