HSA enrollments skyrocket

Account holders top 20 million

By Kathryn Mayer

December 17, 2013 • Reprints

Consumer-driven and high-deductible health plans continue to rise, and now cover 28 percent of those with health insurance, a report out Tuesday from the Employee Benefit Research Institute found.

Health savings accounts continue to dominate the market as enrollments continue to rise. Individuals with an HSA or enrolled in an HSA-eligible plan increased to 20.4 million, up from 17.5 million last year, a 16 percent increase.

This information comes from the 2013 Consumer Engagement in Health Care Survey, conducted by EBRI and Greenwald & Associates.

The group’s other big findings include: 9.7 percent of the population was enrolled in a consumer-driven health plan in 2013, up slightly from 9.6 percent in 2012, and enrollment in HDHPs increased from 16 percent in 2012 to 18 percent in 2013. EBRI also found that employer-funded health reimbursement arrangements, or HRAs, declined over the last year.

The shift toward consumer-driven health plans has been well-documented over the last several years. Along with that has been the general consensus that CDHP enrollees are more cost conscious in their decision-making than those in traditional plans.

“Once again, we found that CDHP enrollees were more likely to use resources to pick their health plan, more likely to use cost information before getting health care services, and more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings,” said report co-author Paul Fronstin, who is the director of EBRI’s health research and education program.

Specifically, ERBI found that those in a CDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctors about prescription options and costs; talked to their doctors about other treatment options and costs; asked a doctor to recommend less costly prescriptions; developed a budget to manage health care expenses; checked the price of a service before getting care; and used an online cost-tracking tool provide by the health plan.

CDHP enrollees were also more likely to take advantage of various wellness programs and be engaged in their choice of health plan.

But Fronstin said it’s not clear from the data whether the fluctuations in consumer engagement can be attributed to plan-design differences or whether various plan designs attract certain kinds of individuals.

“Regardless, it is clear that the underlying characteristics of the populations enrolled in these plans are different,” he said. “As the CDHP and HDHP markets continue to expand and more enrollees are enrolled for longer periods of time, the sustained impact that these plans are having on cost, quality, and access to health care services can be better understood.”

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