HARTFORD, Conn., January 10, 2012 — Employers that replaced their traditional health benefits plans with Aetna HealthFund® consumer-directed plans saved $21.8 million over a five-year period for every 10,000 members, based on a recent study of Aetna (NYSE: AET) health care claims and utilization.  While members with Aetna HealthFund plans spent seven percent less on overall health care costs, the study also showed that these members received more preventive care from their primary care physicians and preventive screenings than members with traditional Preferred Provider Organization (PPO) plans.The results from the 8th annual Aetna HealthFund study – the longest running review of consumer-directed plans in the industry – were based on information from approximately 2.3 million Aetna members. The study compared members with PPO plans to those with Aetna HealthFund plans, which consist of plans paired with Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA). In addition to receiving more preventive care,Aetna members with consumer-directed plans were also more engaged health care consumers, using online tools more than twice as often as members with PPOs.“While health care reform is helping to increase access to health care for millions, many parties within the health care system are still working diligently to address a significant issue – affordability,” said Mark T. Bertolini, Aetna Chairman, CEO and president. “Aetna HealthFund plans are one solution that has a proven track record of controlling health care costs, while also encouraging consumers to become more engaged in their own health care.” Employers that completely transitioned to Aetna HealthFund plans saw the most dramatic cost savings, while employers who simply offered Aetna HealthFund plans as an option still saw significant reductions in their health care costs. The employers that offered either the Aetna HealthFund HSA or HRA plan experienced savings of $8 million over five years for every 10,000 members enrolled in all health plan options, even though the other plan options offered had a similar overall health plan.

Aetna HealthFund Members Receiving Recommended Care at Right Time

Although employers who offered Aetna HealthFund plans saw savings in their overall health care costs, the employees with Aetna HealthFund plans continued to access recommended care at a higher rate than members enrolled in other plan options. The study found that:

  • Aetna HealthFund members received screenings for cervical cancer, colorectal cancer, and prostate cancer, as well as mammograms and immunizations, at a higher rate compared to members in PPO plans.
  • Members with Aetna HealthFund plans who have diabetes received the appropriate screenings for their blood sugar (Glycated Hemoglobin A1C test) and cholesterol (lipid screening) more frequently than diabetic members in PPO plans.
  • Aetna HealthFund members with chronic conditions such as diabetes, congestive heart failure, high blood pressure and high cholesterol use the prescription drugs necessary to treat their conditions at similar rates as PPO members.
  • Aetna HealthFund members use generic drugs at a higher rate than members in PPO plans, allowing members to reduce their prescription drug costs and generating approximately four percent pharmacy cost savings for employers.

Best Practices
In addition to the quantitative results of the study,Aetna also reviewed the practices of plan sponsors who were included in the study to determine the best approaches for maximizing the value of Aetna HealthFund plans. Some of the common themes consistent with employers who saw the most significant cost savings were:

  • Promoting a business culture that actively supports employees in being more active and involved health care consumers;
  • Providing tools and resources like the Member Payment Estimator that support making smart choices about health, spending and overall wellness at all stages of health;
  • Offering incentives for healthy behaviors and to help increase plan adoption; and
  • Encouraging employees to enroll in the consumer-directed plan option through plan design, lower or no employee premium contributions, and employer contributions to the HSA or HRA.

The study looked at nearly 2.3 million members, who consisted of approximately 645,000 Aetna HealthFund members and approximately 1.65 million members whose employer offered an Aetna HealthFund product but who chose another product. The study period draws experience from nearly a decade of claims data.