In an effort to control health care spending, many large employers are including "consumer-directed" health plans (CDHPs) among their coverage options for employees. These plans require consumers to choose between spending in the current year and accumulating funds for the future. But despite the increasing prevalence of CDHPs, there is little systematic evidence of best practices in implementation and consumer engagement.

To evaluate the use of CDHPs in the workplace, the California HealthCare Foundation and the Robert Wood Johnson Foundation funded a four-year study to examine the experiences of 42 large employers (median employee population of 37,000) offering one or more CDHP plans. The goal of the research was to analyze high-deductible health plan designs, information tools, cost, quality of care, and other plan characteristics.

This research brief, based on an employer survey and interviews, offers the first view of findings from the 2003-07 study. It focuses on the implementation experience, including the rationale and design of CDHPs, rollout and enrollment, support tools and resources for enrollees, and strategies to boost enrollment rates. Subsequent reports will focus on cost and quality outcomes.

While confirming that each company's experience is unique, the report identifies common themes, including considerable implementation challenges and the need to engage consumers in making better health care decisions. The employers surveyed were optimistic about the future of CDHPs but recognized the value of choice.

The complete report is available as a Document Download.