HSAs Affect Health Care Utilization


Health savings accounts and other consumer-directed insurance products can help lower health care utilization and encourage better health behaviors, according to an industry expert.

Consumers “begin to recognize that the behaviors that they have can lead to a health outcome that can actually cost them money in the long run,” said Doug Kronenberg, chief strategy officer for Lumenos, an Alexandria, Va.-based company that sells health savings accounts.

“And therefore they begin to think about changes in their behavior that can impact that health care,” he said.

When an employer or insurer combines that with a program showing consumers the financial benefits of changing their behavior and offers support tools, consumers really become engaged in their health care, Mr. Kronenberg said in a teleconference sponsored by the Kaiser Family Foundation. For example, employers can create financial incentives for consumers to complete a health risk assessment.

Health savings accounts (HSAs) were authorized under the Medicare Modernization Act of 2003 and are portable accounts that consumers can use to pay for certain qualified medical expenses.

The accounts are generally offered in conjunction with a high-deductible insurance plan, and both consumers and employers can contribute to the accounts. HSAs and similar accounts, such as health reimbursement accounts, can also create big savings for employers, Mr. Kronenberg said. With these types of plans, consumers tend to see the money as their own, and utilization of health care services typically drops.

But Mila Kofman, J.D., assistant research professor at the Health Policy Institute at Georgetown University, Washington, said that HSAs coupled with high deductible plans are just shifting the cost burden for health care from the insurer and the employer to the consumer.

One of the possible pitfalls is that consumers who are facing large deductibles each year will forego needed medical care because they can't afford it. This could raise the cost of health care if consumers skip or delay screenings and other preventive care that identify problems early.

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