title: Consumer-directed health plans: do doctors and nurses buy in?
abstract: OBJECTIVE
  Aiming to increase healthcare value, consumer-directed health plans (CDHPs)-high-deductible health insurance plus a personal spending account-equip enrollees with decision-support tools and expose them to the financial implications of their medical decisions. This study examines whether medically knowledgeable consumers are more or less likely to select a CDHP than individuals without medical knowledge.
  
  
  METHODS
  Using University of California Los Angeles (UCLA) human resources data, our observational cross-sectional study analyzed the health plan enrollment choices of 3552 faculty and 8429 staff employees.
  
  
  METHODS
  We compared CDHP selection in 2 cohorts: 1) physicians and nonphysician faculty and 2) nurses and nonmedical staff. We used probit regression models to predict CDHP selection, adjusted for job title, demographics (ie, age, gender, race/ethnicity, education, employee income), and coverage type (eg, single).
  
  
  RESULTS
  Approximately 5% of UCLA employees chose the CDHP. After adjusting for sociodemographic characteristics and coverage type, physicians were less likely to choose these plans than nonmedical faculty, when all other covariates were fixed at their means (predicted probability change [ΔP], -1.6%; standard error [SE], 0.8%; P = .05). Nurses also appeared less inclined to choose these plans than nonmedical staff, which approached statistical significance (ΔP, -1.9%; SE, 1.0%; P = .07).
  
  
  CONCLUSIONS
  Overall low rates of CDHP selection were observed in consumers with and without medical knowledge. Although physicians and nurses seem to be better positioned as CDHP consumers, they appeared less likely to select these health plans compared with nonmedical faculty and staff in our study.
authors.affiliation: UCLA Robert Wood Johnson Foundation VA Clinical Scholars Program, 10940 Wilshire Blvd, Ste 710, Los Angeles, CA 90024. E-mail: lleung@mednet.ucla.edu.
authors.forename: Lucinda B
authors.initials: LB
authors.lastname: Leung
authors.forename: José J
authors.initials: JJ
authors.lastname: Escarce
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002140:California; D002755:Choice Behavior; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D003669:Deductibles and Coinsurance; D005260:Female; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009726:Nurses / Q000523:psychology*; D010820:Physicians / Q000523:psychology*