Study Highlights Knowledge Gaps Among Health Insurance Consumers
A recent report from the Employee Benefit Research Institute (EBRI) and Greenwald Research has uncovered a surprising information deficit among health insurance enrollees in the United States. The study, however, also highlights a strong interest in smart health technology and data sharing.
The 2024 Consumer Engagement in Health Care Survey (CEHCS), which surveyed over 2,000 privately insured adults, revealed that while most enrollees understand basic terms like premiums and deductibles, many struggle with the complexities of prescription drug copays and maximum out-of-pocket limits. The findings further indicate a growing reliance on technology, with six in ten enrollees using smart health devices – yet many wish their health data could be better integrated with their care providers.
Dr. Paul Fronstin, the director of Health Benefits Research at EBRI, pointed to these results as evidence that consumers often dedicate minimal time to selecting their health plans and may lack the essential information needed to make informed decisions. “More education is needed,” Fronstin stated. “While they are definitely taking advantage of new tech opportunities to make informed decisions, they also seem to need additional input from their health care providing team.”
The survey, conducted between October 24 and November 25, 2024, focused on individuals aged 21 to 64. Key findings demonstrate that 86% of respondents understood the concept of a premium, and 82% knew what a deductible was. In contrast, only about 25% correctly identified that prescription drug copays can vary depending on the specific medication. Many were also unclear on the details of out-of-pocket maximums. Interestingly, enrollees in high-deductible health plans (HDHPs) generally showed more understanding of these terms compared to those in traditional plans.
Despite widespread satisfaction with their healthcare in general, cost concerns remained a significant issue for many. While nearly two-thirds of respondents expressed high satisfaction with their health care, a substantial portion reported dissatisfaction with out-of-pocket costs. Notably, 14% of enrollees were unhappy with the cost of prescription drugs, and 21% expressed dissatisfaction with other out-of-pocket expenses.
The survey additionally confirmed the increasing role of smart health technology in people’s lives. Over 40% of respondents currently utilize a health-tracking app, wearable device, or similar technology. HDHP enrollees were more likely to embrace these tools. A striking three-quarters of users reported that these devices have improved their access to care. However, a significant majority desired the ability to share their health data with their providers: 66% with doctors and 60% with insurers.
Health Savings Accounts (HSAs) also featured prominently in the report. The results showed that 56% of respondents had opened an HSA for tax benefits, and 53% used it to save for future health expenses. Perhaps surprisingly, two-thirds were using their HSAs to pay immediate medical costs, while a smaller 39% were specifically saving for retirement health expenses.
Furthermore, the survey revealed that most enrollees spend minimal time selecting their health plans during open enrollment. In fact, half of the participants reported making their decision in under an hour. Participants mainly relied on annual benefits guides, but HDHP enrollees were increasingly using online portals. Despite this rushed decision-making process, a high 90% of respondents reported high satisfaction with the enrollment process.
The study also provided insights into the sources of health coverage. The data indicated that the majority of privately insured individuals obtain coverage through their own employer (61%) or a spouse’s job (20%). Just 19% buy coverage directly, either through insurers (11%) or through government exchanges (8%).
Sara Rubinstein, director of Healthcare at Greenwald Research, gave her assessment that while open enrollment satisfaction is high, substantial room for improvement still exists. “The bottom line here is that health plan knowledge is generally low and employees do not spend much time making these decisions,” Rubinstein said.
