"It's a little troubling if you are segmenting the risk pool," says Karen Davis, president of the Commonwealth Fund, an independent health-research firm. "It's hard to figure out how you are going to save when you are spending more money on healthy people you didn't have to spend much on before."

That hasn't been the experience of Hannaford, says Hayes. Even before the company began offering a CDHP as the only option, it didn't segment the population. In fact, a number of employees with chronic conditions opted for the CDHP over other options. Hayes attributes this to the plan's features, including tools like nurse help lines and a comprehensive Website with information on providers. Further, employees rarely have to deal with the dreaded gatekeepers that sit atop managed care systems.

In fact, Hayes says it's the access to information, not the cost-controlling mechanism, that will have the real effect on the health system. "The Internet will revolutionize the way health care is delivered in this country," he predicts.

Maybe. It remains to be seen whether consumer-driven plans will truly catch on with employers and employees. Certainly, the approach has its limitations. "If you are looking at this as the answer to all the health-care problems, it's not," says Hayes. "But it's a good first step." Getting employees engaged in the purchase of their health care, he says, is a powerful idea. "Giving them the tools to do that is the key to making it work."

Another key: the honor system. With HSAs, the employee has the responsibility for making sure the account's funds are used for health-related costs. "It's between the individual, the IRS, and God what the money is spent on," says Domaszewicz. "Someone could go down to the corner store and buy a six pack of beer with funds from the account."

Joseph McCafferty is editor of CFO Human Capital.

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