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Survey examines generational differences in consumer involvement in health-care plans

By Eric Reinhardt


Millennials are more involved than other generations in making health-care choices, including some that are costly for health-plan sponsors.

That’s among the “key” findings on generational differences in a survey that the Washington, D.C.–based Employee Benefit Research Institute (EBRI) released April 27.

The EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) is an online survey that examines issues surrounding consumer-driven health care.

It looked at issues like the cost of insurance, cost of care, satisfaction with health care, satisfaction with health-insurance plans, reasons for choosing a plan, and sources of health information.

EBRI and Washington, D.C.–based Greenwald & Associates, Inc. co-sponsored the survey, with support from seven private organizations.

In its news release about the survey, EBRI noted it focused on differences in consumer “engagement” in health care by generational cohorts — millennials, baby boomers, and generation Xers.

When it comes to overall satisfaction with their health-care plan, 59 percent of baby boomers are extremely or very satisfied, compared with 54 percent of millennials and 53 percent of generation Xers.

Also, 72 percent of baby boomers are extremely or very satisfied with the quality of health care received, compared with 66 percent of generation Xers and 67 percent of millennials

At enrollment and when involved with the health system, millennial respondents indicated higher rates of specific behaviors that contribute to being “more engaged” health-care consumers.

However, they are also more likely to request a brand-name drug over a generic.

Plan sponsors “may want to experiment with targeted ways to lower plan costs among this subset of their participant population,” EBRI said.

The survey also found millennials reported “greater engagement” with cost-conscious behaviors that many plan sponsors “encourage” through their health-plan design and participant education.

The behaviors included seeking the cost of a procedure before receiving services, according to EBRI.

Plan management
Millennials value and are more satisfied than other generational cohorts with aspects of plan management that are directly within a plan sponsor’s control.

More than other generational cohorts, millennials are satisfied with the process of enrollment, including the information available to help understand health-plan choices.

Millennials are more likely than baby boomers and gen Xers to be extremely or very satisfied with the ease of selecting a health plan, the information available to help understand health plan choices, the number of health plans to choose from, and availability of affordable health plans.

Between 50 percent and 62 percent of millennials were extremely or very satisfied with these aspects of health plan choices, whereas 41 to 50 percent of baby boomers and 37 to 48 percent of generation Xers were extremely or very satisfied.

At the same time, millennials are more satisfied with the availability of affordable health plans at enrollment and their personal financial experience of out-of-pocket costs.

The survey found that 58 percent of millennials are extremely or very satisfied with out-of-pocket costs for prescription drugs, compared with one-half of baby boomers and one-half of gen Xers.

Similarly, one-half, or 48 percent, of millennials are extremely or very satisfied with out-of-pocket costs for other medical services, compared with 4 in 10 among baby boomers and generation Xers.

Millennials are slightly less satisfied with health-system features that plan sponsors have less control over, including quality of health care received and doctor choice.

This is an issue plan sponsors may want their insurance partners to address, the researchers contend.

Smoking prevention
The survey also found that plan sponsors may have “more leverage” to encourage millennials to stop smoking.

This research shows that millennials have the highest rates of regular exercise and normal weight, yet “paradoxically” are more likely to smoke.

Given the higher overall involvement rates, plan sponsors may want to experiment with plan design and education to decrease the rates of smoking among the youngest generational cohort, the researchers say.

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