Recent analysis by HCCI finds that enrollment in consumer-directed health plans (CDHPs) increased dramatically since 2008. Nationally, nearly a third of commercially insured individuals were enrolled in a CDHP in 2017, up from 7.5% in 2008. Over ten years, enrollment in CDHPs doubled in 85 of the 88 metro areas studied.

High-deductible health plans (HDHPs) have become increasingly common for people covered by employer-sponsored insurance (ESI). HDHPs present a trade-off for consumers, offering lower premiums in exchange for more exposure to out-of-pocket payments. CDHPs are a type of HDHP that typically include a health savings account (HSA) or a health reimbursement arrangement (HRA).

Nationally, the percent of commercially insured individuals enrolled in a CDHP quadrupled between 2008 and 2017, from 7.5% to 31.9%. Although CDHP enrollment increased in all metro areas studied, the magnitude of the increase in enrollment varied. In 2017, CDHP enrollment exceeded 20% in 84 metropolitan areas, compared to only four metropolitan areas in 2008. Manchester, New Hampshire had the largest increase in percent CDHP enrollment over ten years, from 7.2% to 51.9%. Shreveport, Louisiana had the smallest increase, with 5.2% of the commercially insured enrolled in CDHPs in 2008 and 13.3% enrolled in 2017. Use the interactive tool below to see how your area changes in percent CDHP enrollment over time.

Previous HCCI research assessed overall spending among individuals enrolled in CDHPs, including differences between people with and without chronic conditions.