Aon Consulting today released a research brief confirming the long-term positive impact of consumer-directed health (CDH) care. Among the findings, this research brief (which can be found at http://www.aon.com/cdh_impact_research_brief ) shows that when health promotion and wellness programs are integrated with an overall CDH plan, members are positively motivated to modify behavior.

"CDH provides significant motivation for employees to spend their health care dollars wisely, and one of the best ways to do this is by developing and maintaining a healthy lifestyle," said Tom Lerche, senior vice president with Aon Consulting.

Health promotion and wellness programs connected to more traditional health plans have experienced limited success due to a lack of both personal and financial motivation. However, we now have evidence that CDH works with promotion and wellness programs to improve personal health status and lower claims."

Plan data selected for analysis were provided by South Africa-based Discovery Health and its subsidiaries, including U.S.-based Destiny Health, which together cover more than two million lives and, with few exceptions, offer plans only on a full-replacement basis.

"We focused this research on organizations that only have CDH coverage plans," said Lerche. "This allowed us to address claims from skeptics that positive results are merely due to cost shifting or adverse selection, which suggests that only the healthiest people choose a CDH plan. The results reinforce our belief that by leveraging the power of consumerism, CDH can play a role in bringing the health care cost spiral under control."

Additional findings from the survey were:

CDH plans with integrated health promotion and wellness programs achieve notable success in positively motivating members and modifying their behaviors.

Discovery's Vitality Program offers monetary, vacation and merchandise rewards for healthy behaviors including seeking preventive care, lowering cholesterol levels and improving one's body mass index.  Thirty three percent of the members of Discovery's U.K. plan, offered in collaboration with PruHealth, report changing their behaviors specifically to earn points under the program.  Also in response to the program, more than 80 percent of Destiny Health Vitality participants in the U.S. report starting either a nutrition or exercise program in the prior 12 months.

Plans that include a wellness/incentive plan and offer riders for individuals with chronic conditions work well for both the healthy and the sick.  By providing first-dollar coverage for maintenance medications (outside the employee's health savings account), Discovery has been able to assist its South African members with chronic disease to accumulate savings, thus promoting equity and ownership.  In addition, Destiny Health's members with chronic disease are eligible for incentives based on completion of disease management programs, and cash-based recognition for participation in risk-reducing programs, such as smoking-cessation, weight-loss and exercise.

CDH members consume less health care when paying from their HSAs, but do not accomplish this by avoiding necessary care.  Rather, the savings trace to a reduction of more discretionary spending.  For example, chiropractic care runs less than two-thirds the industry standard, and emergency room visits are 15 percent below the norm.

Short-term cost-saving behaviors do not result in long-term ill effects.  Members who have been in the Discovery and Destiny Health plans the longest continue to exhibit lower claims and hospital admissions -- a result that would not occur if savings were the result of skipping preventive care.  On the contrary, in the analyzed plans, immunizations and well-baby care ran 12 percent and 40 percent, respectively, above applicable industry norms.