title: Tales from the new frontier: pioneers' experiences with consumer-driven health care.
abstract: OBJECTIVE
  To conduct site visits to study the early experiences of firms offering consumer-driven health care (CDHC) plans to their employees and firms that provide CDHC products.
  
  
  METHODS
  A convenience sample of three firms offering CDHC products to their employees, one of which is also a large insurer, and one firm offering an early CDHC product to employers.
  
  
  METHODS
  We conducted onsite interviews of four companies during the spring and summer of 2003. These four cases were not selected randomly. We contacted organizations that already had a consumer-driven plan in place by January 2002 so as to provide a complete year's worth of experience with CDHC.
  
  
  RESULTS
  The experience of the companies we visited indicated that favorable selection tends to result when a CDHC plan is introduced alongside traditional preferred provider organization (PPO) and health maintenance organization (HMO) plan offerings. Two sites demonstrated substantial cost-savings. Our case studies also indicate that the more mundane aspects of health care benefits are still crucial under CDHC. The size of the provider network accessible through the CDHC plan was critical, as was the role of premium contributions in the benefit design. Also, companies highlighted the importance of educating employees about new CDHC products: employees who understood the product were more likely to enroll.
  
  
  CONCLUSIONS
  Our site visits suggest the peril (risk selection) and the promise (cost savings) of CDHC. At this point there is still far more that we do not know about CDHC than we do know. Little is known about the extent to which CDHC changes people's behavior, the extent to which quality of care is affected by CDHC, and whether web-based information and tools actually make patients become better consumers.
authors.affiliation: Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Lo Sasso
authors.forename: Thomas
authors.initials: T
authors.lastname: Rice
authors.forename: Jon R
authors.initials: JR
authors.lastname: Gabel
authors.forename: Heidi
authors.initials: H
authors.lastname: Whitmore
mesh_terms: D003258:Consumer Behavior / Q000706:statistics & numerical data; D017046:Cost Savings; D003659:Decision Making, Organizational; D003669:Deductibles and Coinsurance; D017049:Employer Health Costs; D006264:Health Benefit Plans, Employee / Q000592:standards*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D020402:Medical Savings Accounts / Q000191:economics / Q000458:organization & administration*; D014481:United States