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Now that consumer-driven health plans are gaining enrollees, some payers are expanding their use of information technology to support these high-deductible plans.

Forty-seven percent of 453 large U.S. employers surveyed in March indicated they offer a CDHP, up from 39% in a similar survey conducted a year earlier, according to Watson Wyatt Worldwide, a Washington-based research firm.

A total of 54% of respondents to the latest survey also indicated they intend to continue offering or will unveil such a plan by 2009.

Those companies that offer a CDHP said they had enrolled 15% of their employees in these plans as of March, up from 10% a year ago.

Many payers offering CDHPs initially invested in technologies to enable enrollees to create health savings and reimbursement accounts to manage their payments. Some also offered members multi-function payment cards that they could use to make withdrawals from their accounts and verify insurance coverage. And many created Web sites to help consumers compare health care costs and benefits. " Now, many of these payers are taking automation to the next level.

“Payers are doing a lot more assessment of their CDHP tools to see how members are using them,” says Barbara Flitsch, senior consultant at Watson Wyatt Worldwide. “Before it was a mad dash to get them out there and see how many members they could get on their site right away. Now the research is more sophisticated.”

As a result of such assessments, some payers are adding more detailed health cost and quality information to their Web portals. Others are adding enhanced functions, such as enabling members to better manage their accounts and access claims information.

Further, some payers are pioneering new technologies for consumer-driven health, such as real-time claims adjudication. And others are adding educational content to their Web sites or offering CDHP enrollees access to personal health records.

“There has been a real refinement and improvement of the baseline tools that were created years ago,” Flitsch says. “But consumers ultimately have to drive these tools. If they don’t, how will we know what works?”

Wish List

After almost five years of improvising with its health benefits administration system, Meritain Health gave its vendor a wish list of refinements for the application so it could better support CDHPs.

The Buffalo, N.Y.-based self-funded health plan had created member payment accounts within the system, from MphasiS Healthcare Solutions, Phoenix, when it began offering CDHPs. It also issued members prepaid health cards from Evolution Benefits, Avon, Conn.

But the payer always intended to enhance its use of I.T. as its CDHP enrollment grew, says Lisa Taras, director of requirements management and systems solutions.

“We wanted to enable more flexibility for our employers and more options for our members,” she says. “So we developed a dream list of what a CDHP application could and should do.”

About 18 months ago, Meritain approached MphasiS about developing an application to support its CDHP. The health plan went back to its core system vendor for the application to ensure it could easily integrate with its existing software and the CDHP shortcuts in it, Taras says. The health plan also wanted the application to support its prepaid health cards and be customizable for each of its employers’ specific plan rules.

On Jan. 1, it began rolling out the new software, which gives health plans and CDHP members a single portal to view balances and contributions as well as transactions from prepaid health cards. It also includes built-in functionalities that reflect each of its employers’ specific plan rules for eligibility, funding, payment and rollover terms. Meritain previously maintained such rules through manual overwrites in its core system.

The new application also can exchange and analyze transactions with the various pharmacy benefit management companies the employers use. The CDHpac software inte grates with the vendor’s HEALTHpac system that Meritain uses.

Meritain also internally developed a Web portal to manage its Healthy Merits wellness incentives program. The program enables members to participate in various health-related activities, such as volunteer blood draw analysis offeredby their employers, to receive extra money in their HRAs. The health plan also now offers Web-based tutorials in the portal to inform members about their plan.

Piecing It Together

Blue Cross Blue Shield of North Carolina also is working with key I.T. vendors to add new functions as its CDHP grows.

The Durham-based payer implemented the eExchange system from Benefitfocus, Charleston, S.C., to manage enrollment data transfer. But it later purchased additional technologies from the vendor, including a plan comparison application, as its CDHP grew, says Bryan Engle, strategic marketing consultant.

The Blues plan also implemented HSA tools from Affiliated Computer Services, Dallas. It invested in hospital and drug cost comparison applications from Subimo, now owned by New York-based WebMD Health Corp., and developed its own health care cost estimator that uses data from past claims.

Once it launched its CDHP in 2006, the Blues plan took a fresh look at its I.T. needs.

“We were evaluating the market to see what the key needs for CDHP members would be,” Engle says. “Some of it was driven by what we wanted to offer, and some was what was already being offered in the marketplace.”

As a result of the evaluation process, the Blues plan decided to augment its original CDHP technologies by extending some of its vendor partnerships as well as developing a few applications internally.

For example, it implemented the eEnrollment Web-based application from Benefitfocus to consolidate enrollment for members in all its plans.

It also implemented the vendor’s YourPlan Comparison application that aggregates information from all these plans to enable members to evaluate their different options and costs.