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Can HSAs Lead to Healthier Behaviors?

Among a number of positive aspects of health savings accounts (HSAs), new research finds another.

More precisely, a recent report from the non-partisan Employee Benefit Research Institute (EBRI) found that adults who were in a consumer-driven health plan (CDHP) or high-deductible health plan (HDHP) were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors.

The 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) found 14% of the population was enrolled in a CDHP and 14% was enrolled in an HDHP, a slight increase for both since 2015. CDHPs refer to health plans that have a deductible of at least $1,300 for individual coverage and $2,600 for family coverage in 2016, and include either an HSA-eligible health plan, with or without the HSA, or a health reimbursement arrangement (HRA).

Of course, the theory behind CDHPs and HDHPs is that the cost-sharing structure is a tool that will be more likely to engage individuals in their health care, compared with people enrolled in more traditional coverage. Among individuals enrolled in CDHPs, 56% (16.3 million) opened an HSA. It was more common for employers to contribute to an HSA in 2016 than in the past, and the dollar amount also increased.

As for those behaviors, among privately insured adults ages 21-64 who received health care in the past 12 months, those in a CDHP were more likely than those with traditional coverage to have:

  • said they checked whether the plan would cover care (54% CDHP vs. 44% traditional);

  • asked for a generic drug instead of a brand name (48% CDHP vs. 37% traditional);

  • talked to their doctor about prescription options and costs (41% CDHP vs. 34% traditional);

  • asked a doctor to recommend less costly prescriptions (40% CDHP vs. 30% traditional);

  • talked to their doctor about other treatment options and costs (39% CDHP vs. 32% traditional);

  • developed a budget to manage health care expenses (28% CDHP vs. 22% traditional); and

  • used an online cost-tracking tool provided by the health plan (31% CDHP vs. 20% traditional).

The 2016 CEHCS found that high deductibles were influencing new behaviors often encouraged by employers and insurers. CDHP enrollees and HDHP enrollees were more likely than traditional-plan enrollees to report that they tried to find cost information. They were also more likely to participate in wellness programs.