Enrollment growth in consumer-directed or high-deductible health plans stalled last year, according to a survey by the Employee Benefit Research Institute and the Commonwealth Fund.

"Enrollment in CDHPs and HDHPs is virtually unchanged from 2005," says the survey. "Only 1 percent of the privately insured population ages 21–64 are currently enrolled in CDHPs, representing 1.3 million individuals ages 21–64."

There doesn't seem to be anything on the horizon to suggest that the movement will be jumpstarted, either. Those in CDHPs or HDHPs were less satisfied with the quality of the health care they received than those in comprehensive health plans. Further, those in CDHPs or HDHPs were less likely to recommend such a plan to a friend or co-worker, thereby nullifying the vital word-of-mouth boost that any new product needs.

The data come from interviews with 3,158 privately insured adults ages 21–64.

Satisfaction with quality of health care received, by type of health planLikelihood of recommending health plan to friend or co-worker, by type of health planComprehensive = health plan with no deductible or <$1,000 (individual), or <$2,000 family.

HDHP = high-deductible health plan with deductible $1,000+ (individual), $2,000+ (family), no account.

CDHP = consumer-directed health plan with deductible $1,000+ (individual), $2,000+ (family), with account.

Note: Percentages do not always add up to 100 percent because of rounding.

Source: "Consumerism in Health Care Survey, 2006: Early Experience With High-Deductible and Consumer-Driven Health Plans," Employee Benefit Research Institute/Commonwealth Fund.

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There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

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Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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