Consumer-driven healthcare (CDHC), defined narrowly, refers to third-tier health insurance plans that allow members to use health savings accounts (HSAs), Health Reimbursement Accounts (HRAs), or similar medical payment products to pay routine healthcare expenses directly, but a high-deductible health plan protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays medical claims using a prefunded spending account, often with a special debit card provided by a bank or insurance plan.
If the balance on this account runs out, the user pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances>or to invest for future expenses. CDHC plans are subject to the provisions of the Affordable Care Act, which mandates that routine or health maintenance claims must be covered, with no cost-sharing (co-pays, co-insurance, or deductibles) to the patient.
This system is referred to as "consumer-driven healthcare" because claims are paid using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. According to economist John C. Goodman, "In the consumer-driven model, consumers occupy the primary decision-making role regarding the healthcare they receive."Read More»