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Policy, Politics, & Nursing Practice
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Defined-Contribution Health Plans: An Emerging Paradigm

Kathleen S. Cummings, MS, RN

University of Maryland School of Nursing in the Department of Organizational Systems and Adult Health

Mary S. Tilbury, EdD, RN, CNAA, BC

University of Maryland School of Nursing in the Department of Organizational Systems and Adult Health

Many employers, especially small businesses, are looking for better ways to provide their employees with health care coverage. This goal is prompted by employer-based insurance programs that do not meet employee or employer needs. Costs are high and employee coverage is typically limited or entirely absent. One potential solution now in the marketplace is defined-contribution (DC) health plans. This insurance program allows the employee to structure the content of their coverage from an options menu. Employers pay a portion of the premium, and employee costs vary based on the coverage options selected. The implications of DC for consumers, employers, payers, and providers are far reaching. This model could dramatically affect consumer service choice and consumption patterns. It is vital that nursing analyzes this emerging product and responds so that the services covered are adequate, of high quality, and can successfully compete in today's health care marketplace.

Key Words: defined-contribution health plan • health insurance • consumer-driven health insurance • health care benefits

Policy, Politics, & Nursing Practice, Vol. 4, No. 4, 281-287 (2003)
DOI: 10.1177/1527154403258310
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