HSAs Lead To Slightly Less Health Care Usage, Spending

By Cyril Tuohy

InsuranceNewsNet

Employees covered by a high-deductible health plan (HDHP) funded through a health savings account (HSA) used fewer preventive care services and spent less on those services than employees in a control group using traditional managed care, according to a new study.

The study, conducted over five years by the Employee Benefits Research Institute (EBRI), is important because it sheds light on health care usage patterns for a health benefits model that employers across the nation are rapidly adopting.

Overall, use of preventive services by the 18,419 employees surveyed from 2006 to 2010 was a mixed bag, the EBRI researchers found. Annual physicals, child visits and preventive doctor visits were lower in some years following the adoption of the HSA-eligible health plan.

Cholesterol testing for adults with cardiovascular disease was lower in the first year, although medication monitoring fell in all years in which employees were tracked.

By contrast, screenings for breast cancer were higher in the HSA-eligible plan but lower for colorectal cancers, and rates for cholesterol testing showed no overall change over the five-year period, the study found.

Paul Fronstin, director of EBRI’s Health Research and Education Program and co-author of the report, said the study "represents one of the longest observation periods reported with a full-replacement [consumer-directed health plan], and it is one of the few studies with a matched control group."

Health care spending for the HSA group in the study was lower than for the control group. Mean health care costs for 2006 came to $2,407 for the HSA group and $2,498 for the control group. Of the $2,407 mean health care cost borne by the HSA group, $1,948 was absorbed by the plan sponsor, compared with $2,001 absorbed by the plan sponsor for the control group.

Proponents of high-deductible plans say the model will help lower the rate of health care usage as more people are sensitized to the true cost of health care services. The more that people pay in out-of-pocket expenses before the insurance plan kicks in, the more likely they are to shop around for lower-cost services or cut back on redundant medical visits, the proponents claim.

The number of enrollees with HSA/HDHPs rose to nearly 17.4 million in January 2014, up from 15.5 million in January 2013, according to a census by America’s Health Insurance Plans released earlier this year.

Other surveys have predicted rapid adoption of HSAs among employers in the coming years, in part due to health care reform.

Cyril Tuohy is a writer based in Pennsylvania. He has covered the financial services industry for more than 15 years. Cyril may be reached at cyril.tuohy@innfeedback.com.

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Cyril Tuohy is a writer based in Pennsylvania. He has covered the financial services industry for more than 15 years. He can be reached at cyril.tuohy@innfeedback.com.