Online Health Benefit Tools May Present Unexpected ‘Pitfalls,’ Study Says
Internet-based tools for health benefits decision-making and administration offer "some advantages" to employers and employees but may also present unexpected "pitfalls," according to a new report by the Commonwealth Fund. The report, titled "E-Health Options for Business: Evaluating the Choices," says that eHealth defined-contribution plans may give consumers greater control over health care decisions, but they also can increase costs and reduce access to coverage for older and sicker employees. These plans give employees individual accounts containing funds that they monitor and spend on health care at their own discretion. The report also cautions employers that Net-based tools for benefits administration functions, such as enrollment and claims, can carry "hidden costs" that offset the savings they promise. Although eHealth defined-contribution plans give employees "more choice in selecting health plans, benefits and providers," information on the quality and performance of health plans and providers is "limited and not standardized," the report states. The report also questions whether employees want more responsibility for health care decisions. The report cautions that Internet-based "health savings" or "personal care" accounts, a form of defined-contribution plan, may upset the "natural risk pooling of employer-sponsored coverage." Defined-contribution plans are intended to give employees a financial incentive to help control health care costs. Under this model, however, workers with little need for health services do not subsidize care for workers who require more health care. That could increase costs and limit access to care for those who need it most, according to the report.
The report advises employers to consider potential new costs associated with Net-based benefits administration. Those costs may include purchasing and maintenance of online applications, training employees to use the tools and lost productivity if workers spend more time managing benefits while at work. Further research is needed to properly assess the long-term implications of Net-based benefits management for cost, quality and access to care, the report concludes. In the interim, the authors recommend that employers limit their use of online tools to providing employees with health information -- such as provider quality data and treatment options -- while maintaining control of employees' health benefits management (Silow-Carrol & Duchon, "E-Health Options for Business: Evaluating the Choices," March 2002).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.