New research indicates that more consumers are selecting consumer-directed health plans, led by small businesses.

In data released by the American Association of Preferred Provider Organizations (AAPPO), CDHP enrollment grew to an estimated 23 million people last year, up from 18 million in 2008, a 27% increase. The findings were reported in an analysis of Mercer’s National Survey of Employer Sponsored Health Plans.

The data also indicated that CDHP adoption in 2009 was led by small employers, accounting for most of the growth among all employers.

Karen Greenrose

“At a time when employers are faced with the difficult choice of limiting benefits or raising health care costs to their employees, they are turning to CDHPs given the cost savings inherent in these plans,” said Karen Greenrose, president and CEO of AAPPO, in a statement. “We also saw small employers turn to CDHPs at a much greater rate, largely due to this cost savings. CDHPs, which are predominately built on PPO networks, offer the affordability, choice and access that employers and consumers alike are looking for.”

The analysis also indicated that while employers prefer to offer CDHPs with health savings accounts (HSAs), employees are choosing to enroll in CDHPs with health reimbursement accounts (HRAs) at a greater rate. The AAPPO said as consumers look to get “the biggest bang for their buck,” HRAs are more appealing, given that they provide an employer contribution to the employee’s HRA, whereas HSAs do not always do so.

The AAPPO is a national association of preferred provider organizations, located in Washington, D.C.