Aetna Consumer-Directed Health Plans Continue to Save Millions for Employers

Monday, January 28, 2013

10 years of data also shows that Aetna HealthFund members take more control over their health

HARTFORD, Conn. – The 9th annual (NYSE: AET) Aetna HealthFund® study shows that employers that replace their traditional health benefits plans with Aetna HealthFund consumer-directed plans saved nearly $350 per member per year. The lower health care costs result in savings of $20.8 million over a six-year period for every 10,000 members. The Aetna HealthFund study is the longest running review of consumer-directed plans in the industry, drawing experience from a decade of claims data.

Members with Aetna HealthFund plans spent less on most types of health care services, including specialist doctor’s visits, emergency room visits and total pharmacy costs. Despite lower overall health care costs, members with Aetna HealthFund plans received routine preventive care from their primary care doctors 11 percent more than members with traditional Preferred Provider Organization (PPO) plans. Aetna HealthFund members also had higher rates of screenings for cervical cancer (nearly seven percent higher), colorectal cancer (eight percent), and prostate cancer (10 percent), as well as mammograms (six percent) and immunizations (three percent).

“Employers are trying to control rising health care costs by getting their employees to be more empowered when making health care decisions. Aetna HealthFund plans continue to be a proven solution to achieve that important goal,” said Tom Mafale, head of National Accounts sales operations for Aetna. “Encouraging people to receive the right care at the right time is one important way to help reduce health care costs for both employers and individuals. Health care reform has increased access to preventive care, but Aetna HealthFund members still use this type of care more frequently than other members.”

Employers that completely transitioned their employees to Aetna HealthFund plans saw the most dramatic cost savings. However, employers who used several “best practices” identified through the study had cost savings that were almost as high as the employers who completely switched over to HealthFund plans. These best practices include a comprehensive employee communications strategy; offering incentives for healthy behaviors; and a combination of wellness and care management programs.

In addition, employers who simply offered Aetna HealthFund plans as an option still saw significant reductions in their health care costs. The employers that offered an Aetna HealthFund plan option saved more than $190 per member per year for members enrolled in all health plan options.

“Our results over the past decade show that Aetna HealthFund plans can lower an employer’s health care costs while also encouraging members to get the care they need,” said Chris Riedl, head of consumerism and product innovation for Aetna. “Our unmatched experience in this area and member-friendly tools give us the unique ability to help both employers and members with these plans.”

Aetna HealthFund Members: More Engaged Health Care Consumers

Employees with Aetna HealthFund plans use online tools and resources more than twice as often as members with PPOs. This included greater usage of:

  • The Member Payment Estimator, which provides members with real-time out-of-pocket cost estimates for more than 550 commonly used health services based on a member’s personal benefits plan. Aetna’s research has shown that after members use Member Payment Estimator to obtain cost estimates on one of more than 30 commonly selected health care services, they chose the provider whose out-of-pocket cost estimate was on average $170 lower than the average of the estimates they received.
  • Aetna’s Personal Health Record (PHR), which integrates information from claims systems, wellness programs and user-provided information so that members and their health care team have access to robust amounts of health information.
  • Aetna Navigator®, Aetna’s secure member website.

Aetna HealthFund members also demonstrate higher levels of engagement when making health care decisions. These members:

  • Use generic drugs 1.5 percent more frequently than members in PPO plans. Using generic drugs helps members reduce their prescription drug costs and generates approximately four percent pharmacy cost savings for employers.
  • Are 30 percent more likely to participate in disease management programs.

Members with Aetna HealthFund plans who have diabetes also received the appropriate screenings for their blood sugar and cholesterol approximately 10 percent more frequently than diabetic members in PPO plans.

Aetna HealthFund Study Details

The Aetna HealthFund study compared members with Aetna HealthFund plans to those with PPO plans. Aetna HealthFund plans are high-deductible health plans paired with Health Savings Accounts (HSA) or Health Reimbursement Arrangements (HRA).

The study looked at nearly 2.2 million members. Approximately 760,000 of these members had Aetna HealthFund plans. More than 1.4 million of these members had an employer that offered an Aetna HealthFund plan but who chose another product.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 37.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services and health information technology services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see


Ethan Slavin