The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) included a provision that created what are commonly known as high-deductible health plans (HDHPs). The MMA also created health savings accounts (HSAs) to help individuals in high-deductible plans — the only tax-preferred account that gives individuals a “triple tax advantage.” Since that time, employers have taken two paths. Some have offered HDHPs in conjunction with HSAs, the combination of which is commonly known as HSA-eligible health plans or HSA plans. Others have simply raised deductibles in other types of health plans.

It appears that deductibles have been falling in both real and nominal dollars in HSA plans, but they have been increasing in other types of health plans, such as preferred provider organizations (PPOs). Furthermore, employer contributions to HSAs fill in part of the difference in deductibles between HSA plans and PPOs. While a gap remains, the movement of PPO deductibles toward HSA plan deductibles raises a question as to whether differences in deductibles are less of a distinguishing factor when it comes to managing health care use by type of health plan. If that is the case, it is important to understand whether the HSA impacts use of health care services and overall spending.

The purpose of this paper is to examine the impact of plan type on use of health care services and spending. The analysis focuses on enrollees in HSA plans and PPO enrollees who are in health plans with deductibles large enough to be HSA eligible as a way of isolating the impact of the HSA on use of health care services.

Key Findings:

• We find that HSA plans have mixed effects on use of health care services. Inpatient admissions and days were higher in HSA plans than in PPOs. The additional inpatient admissions do not appear to be coming from emergency department visits, as HSA plan enrollees used emergency departments less than PPO enrollees.
• Office visits shifted from specialist visits to primary care visits among HSA plan enrollees.
• HSA plan enrollees filled fewer prescriptions as compared with PPO enrollees.
• When it comes to health conditions, we see vast differences in changes in use of health care services by plan type between those with no health conditions and those with two or more. Among individuals with no health conditions, HSA plans resulted in fewer emergency department visits relative to PPO enrollees, fewer specialist visits, and fewer prescription drug fills, while visits to primary care providers increased. In contrast, among enrollees with two or more health conditions, there were no instances of decline in health care services among those in HSA plans relative to PPO enrollees. Instead, those with two or more health conditions experienced increases in inpatient admissions, inpatient days, and primary care office visits.
• The findings on the impact of HSA plans on spending relative to PPOs largely mimic the findings on use of health care services. Spending on inpatient services was $61.30 per member per year (PMPY) higher among HSA plan enrollees than among PPO enrollees, and spending on primary care visits was $4.20 higher PMPY. These amount to 6 percent and 2 percent higher, respectively, among HSA plan enrollees than PPO enrollees. In contrast, where use of services was lower, spending was also usually lower. Spending on emergency department visits was $19.10 or 7 percent lower PMPY among HSA plan enrollees, and spending on specialist visits was $4.60 or 2 percent lower PMPY. While prescription drug use was lower among HSA plan enrollees, spending on prescription drugs among HSA plan enrollees was not statistically different from spending among PPO enrollees.
• Overall, HSA plan enrollment had no impact on total spending — there was no statistically significant difference in overall spending between HSA plan and PPO enrollees. However, spending was $60.30 or 2 percent lower PMPY among HSA plan enrollees with no health conditions as compared with PPO enrollees, but spending was $2,490 or 6 percent higher PMPY among HSA plan enrollees with two or more health conditions. This higher spending was driven by 21 percent higher spending on inpatient services.

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Figure 5 Figure 9 Use of Health Care Services, by Plan Type, 2021 Effects of HDHP on Spending Relative to PPO in Percentages Figure 7, Effects of HDHP on Use of Health Care Services Relative to PPO, per 1,000 Enrollees ................................. 12 ne e A e W is a p C Els ff nr r ha ndno ppendi he e tte o he w sc olle r c • n it ls a t or r s m llow ipti c on, e k a s, spe , se, c The t on od m om e M. e d ov e x s it m e l w for fin E e s nding is e ., d t d t a im o o c P ic ings o s e e .he a a p rP t t or st on lim ions a om ain im lt ta n th it h st p p nt p a .e re rt e d E e e i, sc te a nr m d o ne K t,r im us olle ium . unde ipti w tL w , p hic .a on or e H A p c s w SA rh inc k le ta st d , y o s a rm c it , f HSA p ugs nd ha h fa la a e lude nd nt n e nge w a s. m he C m d nr pily .R. A la tong t tolle he ny he he ns cMa ov r for in e k on H ts w e e the c SA e r y m K a r spe e r ula e g e H e p nzi st r eg SA la e nding rr a or e y n a e ls . , ss im e lit o 19 offe ot nr or tp a he le 87 r a olle c e of c r cle r la oun . the s u c e ss " t int iv a A s w a p tse e e he lt N e it rh d ta e a e o a of - s not w l st r for lte P is hy he Me a P — k rOs la t nin a a he ttH st ha ss lt hod SA h ca a g e d n P ts on rss e is -g e c of te m r lin P ligib ily c e O e a C a e ser nt lly m la ss ein b le s, offe nr ss im e v d he tic ify olle iff ic s in t re e e a ing s a ta r lt e hr e st s. h p e nt he nd fin P fin a H r nd la t og aa SA ov ha d nc n cings o nost c c e n sp — ia oun p e ra la l inc r v a ll sp ic n ic e s w t n use n a e C b el c d nr e uil o nt e ing nding m ll a olle a id v nc or e of up a s s e b e m ts idit r. for he tong a On x y Paul Fronstin is Director of Health Benefits Research at the Employee Benefit Research Institute (EBRI). M. HSAs Reduce Use of Outpatient Services and Prescription P ha fr follow b sc the iom P erd O e e one . e a e e nin Fi ing n tsl rna r ic ight olle g ha in L he lly .c sc ov nd, ae ly , rong lt s. e a H h ca highe e r SA H ia Ov nin it SA ts a udina e re g e s: a s m rr s, a r se e C ll, or C a g r l Stu av H y e I lw ic a ,SA tc udi ha e a rre d e s. Sp y g p ie n P s fun a tion, la ts: D tehe n Pe aO e d nding hous e p sa nr ee v la dn v e ollm , n for ings me r lop olle unl e on hold m eik nt ee non inpa s, ent ha si si nt a ze - a m nd d te a nd ie ligib ila , lit no nt t CCI y he rVa a im t ser le y y m lida , p p d d w ong v ea e e ic s of e tc p p ion. re te r e s w e on p nde sl ss he la "ight a ion, n e tJou a nt o s $61 lt ts a ly h a nr .l sp a r na olle m nxi c .30 p l o c or eount e nding ee f C ts y lik , e ahr r s t d s e e m onic su ly — he de uc c t m y t o h he tD b w ible ha ae is rs er e e v igh h p e a w a e e se m d a a rw e s no lt , ount yp h r he 40 era ete ( rss he , st 5) im (c ion P a r , oin b MP t 37 is tur he ta su Y i3 seme c nd y ) – a r 83. a lly sh highe nc a nxi ould nt si eg e rr nif a t y a t be i.m e c , a ong u a nsi nd t ng Christopher Roebuck is Preside nt and CEO of RxEconomics, LLC. This Issue Brief was written with assistance from Drug Figure 8, s Eff,e cInc ts of H rD e Ha P on se Sp Use ending Re of lativ I en to p Pa PO tin ien Dolla tr Service s ................................ s; Ov ................................ erall Spend ........... ing 13 PPO HDHP Employee- Child or 1 d a y ae r iff p raa a e rnge r rindic teic nc ula m H ea e SA rin ove t nt or he sp s. The , a la w ltn e rh ca hic all spe nr h a croe olle er e ser ndin ff e ic us s t v ie u ig c nt ha a eb lly n a e a for t gp w a m rH e ins ov e o SA n ng ide t -sa H ed P SA ligib v Pon ing O ple la e am nr n he not one olle aa nd iona lty e h p s, P for P l b la a O nd fut ns ae si nr ur s spe fr.olle om e ndi ne ets. c he ng e ss se on ar m ypod r cim ae rls e a.r is yOn cint ar te h ere p v is ot reit he ts w ed r a ha as r s $4.2 nd, ep ree0 hig nr sent olle ing he es m r tP he MP ay Y v. iew In 2024, the Ins the tits uet ep’s r lans esea had rc to h a hnd avee a d it dor edia uc l st tiba le ff s. A of any t le a vs ie t w $1 s e ,600 xprfo ess r e ind d iv in t idua his l cro ev pe ora rtg a er e a nd tho $3, se 200 of the for a fami uthor ly ca ond vera sh gould e. Inpatient HospiF ta ullilz ations (#) (per 1,000 enrolle O en sl)y Fa mily P 3 o1 li.c 4yho lder Sp 3 o1 u.s 4e Dependent Charlson Charlson E Un Muc The Cv he en th rh r spouse ne a e w oug ff sea , M e h r ic of c c w h ha ha tet he e e lim l s b E pd ., it olic e e A e dlli n d y P hold son B Pon O e e er . nr t o w Rose olle a unde s e a n, s t lsro a st o nd ta the nd hose A d . trhe M iv w a e r it im rk h d of p Fe ae cc nd ha d t u trnge ha c ictk ible t. s in t20 he s la 0 td 7. he re gd "e Va uc us etnoug e lue ible of -B he in HSA h to b ased alth ca Ie ns pH la r ur SA ens aser nc , ea ligib e vnd ic Dee le H s. si , D g IH H tn. SA P w "s m a H s t pe la or a he n lt eh Af e spouse g nr en olle fa eir ra e s, ls ly t ha , t Appendix Figure 1 Figure 9, Effects of HDHP on Spending Relative to PPO in Percentages .................................................................... 14 t im he p a HcSA t of These as e hav aing r m am a(ra ount kcecd e s for ts t o o) 6 p curae rn HSA e rc nt e nt spe a— nd nding the 2 p ,k e e e rspe y ce cnt ont c ia highe r lly ast a n r b, y e rte e w m spe ep eloy n cta iv en e r ly H cont , SA am -re ibut ong ligib ions le HSA he t o a plt la the h p n e H la nr SA n olle a , nd ae nd s t a tha P he Pn P O rep for Pla O e n a em nr ft aolle e yr feees. l not be ascribed to the officers, trustees, or other sponsors of EBRI, Employee Benefit Research Institute-Education Sample Male Female Coverage Coverage in Family in Family in Family = 0 = 2 2 3 April 1 Acc 1o, rd 2 ing 02 to 4 KFF • N , o amo . 6 ng 05 wo rkers with an HSA or health reimbursement arrangement (HRA) in 2023, about four-fifths of ha e The ha xpe d s ha highe fin ried d nc ings b W on e re dd us b e fe E d e yw xc uc of g elus e trible nde he inpa ivae s r lt , ,tth ca ie ha w em nt 19 n p r 5 a e P loy – d Pser w m O e20 is ee v-si n ic only 3. ons reolle s a ,v e nd a s. fa s. nd spe Hm s SA pnding ily ouses e nr cov olle .ea rThe c e acs gount e ha , ini a dtnd e ia a dn l st p for a olic udie v e ar y a lhold a s t gre ge e d e nde re r inc dvuc d s. spo r e t tible o ase foc us o iu n hosp f $3,64 es on /depb e itr 3, w nd a oa l d ednt a hil q y ue s. a els P st They ha o Pions O lare gnr e lik ly oll d e m e sl w e im ight ho s icly c tha ont t rtollin herI e g n cont is for no dre ne adst uc e, dtw ible to heb ra e end c us ost c eoins of con se ur sc rav iou nc ice e s. s w . Of cour as lowse, er, a spe ny nding other w diff as a ere ls nc o e us s (e. ually g., low cop ea r. ym Speent ndi s ng andon pre ov mide erg r ene ncty w orks) Total Spending 0.2% -1% 1% -1% -0.2% -1% 2% -3% -2% ** 6% ** and Research Fund (EBRI-ERF), or their staffs. Neither EBRI nor EBRI-ERF lobbies or takes positions on specific By Paul FronstIin, P npatieh.D., nt Hosp E itamplo l Days ye (#)S e (p t Ben a ert u 1t ,0 o e 0rfi 0 y t e R H nrS oe lA le s ee L sa i )m rch I its, 2 ns 0 0 t4 itut –2 1 0 e 5 2 , 33 .a 9nd M. C 1hris 53.0topher Roebuck, Appendix Figure 1, Statutory HSA Limits, 2004–2023 ............................................................................................. 15 workers had an HSA and one-fifth had an HRA. See Figure 8.4 in https://www.kff.org/report-section/ehbs-2023-section-8- fe ha t ehe nr w d olls e fin a rn e d in a m a ings b veern HD rg ae gy nc e us H y d e P e dd , e of uc how pathe r ible t m a elt nr e of h ca nolle t $3 vis re,300 eis d t s ser iff a.nd v e Iic n cont r e sl fr sight om forr ly non a the s fe t, se -w H ee nr Sg rA rolle spe oup pla e cn e s. s, r ia lis Anr is nd tk olle v sele iw sihil e ts. The s ha c et ion, the d y low fin a a nd ls d eo ings b rt he c aoins c cim ou yur p nt he a ac e nc a td ltof eh condit for tH ha D fe n P H wPeP s on ion, rO p ree a nr ov sc s d olle e ripti reafin e ll use on s ( ed 18 d b r of ug y Data w ould als do ep ba er tpm ot ee nt nt v iais l e its w xpla ana s $19 tions .1 0 o of trhe 7 p ee st ricm ent at elow d ee ffre P ct MP s. Y among HSA plan enrollees, and spending on specialist policy proposals. EBRI invites comment on this research. Ph.D., RxEconomics, LLC D hig ey ho, -deR. duc A. tib , D le.- he C. aC lth he -p rk lain ns , -a w nd ith - M. sav Aing . Csiol. -option/ 1992.. "Adapting a Clinical Comorbility Index for Use with ICD-9-CM Per-Person Inpatient services 6% * 5% 7% * -5% 6% * M7% aximum Out15% -of- *** - 1 0 % -1% 21% *** ® t fil ser The phe els rv , cCCI ic e p thoug nt e ur s a , p aa ose nd nd ls h p o 21 spe of la olic rp tg nding his y e ehold rly c e p follow nt a. e p,Mo re s a rre ris sp e nd t he te ro e c c c tfin e hil iv e xa nt e d dly m r ings b e st )ine n a .udie ls ty he o s us ha eim xa ed p of m a fe ine che w t e of d ar lt m d p h r la or u ser n ty g e v fil ta ic p ls re e g . s, it e on W tehil d us is e q e w ue w of or e st td he ions h d o anot is lt , h ca csu u ha ss ch a rin veeg ser s m tthe he ve ic se w deor ic s a ra e ktsu ion a nd stlt as fur t spe us dhe nding of the re the nc r.. e c The o for ve red Enrollment informE at m io en a rgend ncym De ed pic ara tm l a en nd t Vp isha its r(m #)a (cp ye rc la 1,im 00s fr 0 en om roll ete he s) Ma rketSc 44a 2n .3 Com me r 4c3ia 1.l a 8 nd Benefit Plan Design visits was $4.60 or 2 percent lower PMPY. While prescription drug use was lower among HSA plan enrollees, HSAs Reduce Use of Outpatient Services and Prescription Catch-up Minimum Deductible Maximum Contribution Pocket Limit Administrative Databases." Journal of Clinical Epidemiology, 45(6), 613–619. 3 a spouse indiv Itna isly w idua sior s foc , tg ls h noti iv w e us n th ite h ch ng s on ey trha onic a ecnr tc fix oun olle cond ed te -s fe or i tff in HSA ions ehighe cts m (Fr p rod ons la inpa ns etlin in, Se taie g nd nt m P a p us P k úlv e O es us , e eit d nr ais e , oll a of pe nd oss ew s w it Roe ible hin ho b -tuc su ha ark b e t , jte in h he 20 ct y 13 v e a a a)r r lt ;ia e h p g tnot e ion (i.e ne la ns r w ico w rd ., kit ring ug h d oveus b e re d t e c uc im a(us t Fr e ible )onst e t o of s la g in te he rne g ae ir nd r a e he tnoug Roe ea lth bh to uck, See Buchmueller (2009); Bundorf (2012); Buntin, Haviland, McDevitt, and Sood (2011); Fronstin and Roebuck (2013); and d atabases were used for this analysis. Full-time workers and their dependents who were continuously enrolled in health spending on prescription drugs among HSA plan enrollees was not statistically different from spending among EmergencSu y Dg ep gaes rtm ted ent Citation: Fr -7 ons % tin, P *** a -6ul, a % *** nd M. -8% Chr *** istop -he 1%r Roeb -uc 9%k, *** “HSAs Re -8% duc *** e Use -11% of *** Outp -8 a% tient *** Ser -v 8% ices a ***nd -0.2% Contribution E nrollees with two or more health conditions accounted for the increase in use of inpatient services among HSA plan Drugs, Increase Use of Inpatient Services; Overall Spending Physician's Office Visits (#) 3.6 3.7 *** 2014) e st bst ea t im H us SA a ; .t e w es of he ligib the tle he r a indiv im s ap a w idua caty of ls of tw h isola e it h a inde ting n HD petn he H de P im nt ap rv e aa c lik rtia e of b ly le t he ts on o p HrS ic the A e on sh de ous p pe e ( nde Bof rot nt he - G v aold a ltrh ca ia bb ele rrg e s. The , se Cha rvndr ic aedsa v ., ant Ha an gd ee of l, atn his d K aolst ppra oa d, ch i 20s 17); Fronstin, Sepúlveda, and Roebuck (2013). coverage in each year from 2017 through 2021 were included in the study. Individuals were required to be enrolled in Introduc PPO te ion nrolle In div eis. dua l Family Individual Family Individual Family Limit Figure 4 Fronst Prin, P escripti aulon , and Drugs, M. CI hr nc isrte op ase he Use r Roe of buc Inpa k. 20 tie13 nt . Se "H rv eic alt es; Ove h Carer a Sp ll Sp ending ending aft e Una r Ad ffop ectting ed,” aE Fu BRI ll- Re Iss pue lac B em rieefnt , no. , High 605 - enrollees. As a result, spending on inpatient services was $2,334 (21 percent) PMPY higher among HSA plan enrollees. Primary care physician's office visits 1.9 2.1 *** Physt q ic ha ua iat nlit unm O yf fof ice e he a Vsu isa itlt r se hd c , atr im e e re -inv ceiv ar e -ia 0 d. 1 nt (% Fr const hara -in a 0c.t 1e % rnd is tic Roe s a -0.b r 1e uc % eklim , 20 ina 14 -1t% e ); d us a *s p e -of 0oss .2spe %ible cia sour lty- 1 m c % e es of dicac tions onfounding -0.2 % (Fronst 0 . i.n I 1n th % ande Roe pr -e 0b .sent 1uc %k , 1% Unaffected either a PPO or an HSA-eligible health plan. Further, the annual statutory minimum deductible thresholds (see Appendix 4 2004 $1,000 Dem $2 o ,g 00 r0 aphic an $d 2, 6 O 00 ther Diff$e 5r ,1 e5 n 0ces, by $P 5,l0 a0 n 0 Type, $ 21 0 02 ,0 100 $500 The (Me Em dp icloy are e eP rBeesc ne ripti fit Re on sea Drug, rch I Im nsptritov ute em , A ep nt r, il 11 and , 20 Mod 24e). rniz ation Act of 2003 (MMA) included a provision that created The Cha D rls ed ouc n Como tible H rbeid aity lth P Inla de n Wit x (CCI) h ais H a e a me lth Sa asure vings Ac of heac lth oun sta t: tus A .Fi Mo vere -Y e sp ae r cSt ific udy. ally" , it EB isRI a w Iss eig ue hte Bd rie in f, dno. ex tha 38t8. p redicts Specialist physician's office visits 1.6 1.6 *** Prim W Thi ahe ry s im n it carp e c lie pom hs t yse iha cs iatt no tohe he ffic a p elt rve h con issenc its d e 2% it of ions t*** he , w He 1% SA see d*** id vanot st2% d riff ed e *** uc ree nc -t 0 e he .s in c 1% useha of nge 1% the s in use se ***serv 2% ic of es. he I *** a n lth ca fa2% ct,r e the *** se op rvic 0p .e 4 osit % s bey w pa las t n ty 2% rue pe *** . It is3% * 2018) analy •si ; s, t de Ov la his e yr s in b a isll, HSA valua reab st p le la c si a n e nc ncnr e er ollm indiv scre eidua e nt nin ha ls gd (lik W no eha ly im rsele ap m a cc e tt te on a dl., tthe ot 20 a ir19 l sp he ); e anding t lthe h p clo a ns m —b tfor ina he rtre ion o e a w sons as no f d e tha dst uc ta tt aible is re tic not a silly ze c , si ont p grnif e rolle senc icad nt e for d of iff b a ey n HSA r e th nc e e Figure 1) were imposed to exclude those in PPO plans with comparably lower deductibles. Finally, the presence of a 2005 1,000 2,000 2,600 5,150 5,000 10,000 600 what are commonly known as high-deductible health plans (HDHPs). The MMA also created health savings accounts risk of death within one year of hospitalization for patients with specific comorbid conditions. It is widely used in the extant SpeBy cia P list a oful Fro fice visits nstin, Ph.D., -2 E %mplo *** -ye 2%e Ben *** -2e % fit R ***es -e 2% arch I ** -ns 2%titut *** e, -3a %nd *** M. C -2hris % *** top-he 1%r Roe-buck, 2% *** -0.1% p Diff boss etwible e e er n th e tha nc ose t e eit s w he it B r h no e Ht SA we he ba a e la ltn PP h condit nces or Os ions poss and H a ibly e nd those m SpA loy w P eit la r h cont ns two r ibut or m ions ore e a na s d ble efin d e Hd SA b yp la thn e e CCI nrolle . Am es ong wit h he indivaidua lth condit ls with no ions or cov he ara ialtth r ein ove s. U eim nob brur all spe ser seme vanding bnt le s t ar r hb a ae nge tt w are m ee e d nnt y H na SA (H mRA ip cla )w , n a it ahin nd nd tp P ye p Pre O son, how of enr Holle DHe P es. How v(e Hra , vrila ee m nd, va ein r , Sood sour spending , ce Mc s of D w e p vaot it s $60 te , nt and ia .30 or l b Ma iars. q 2 p uis, er20 ce11 nt) low ; the er v Fr aonst lid Cm o in, P e pd yic ra ig aul l c h , t In oins and form ur M. anc Chr a eti is ra o ttop n e: he in t This rhe Roe r e Bp e bor ne uctk fit is . 20 P clop a14 n D y. right "eBsi ra g en n dd D b -N a y tatam he be a se E am nd w pa loy PPO G s ee a ne ls e o rB ic e r e ne Pq ruir e fit sc e HDHP Re rd ip sea for tion D rtc he h I r ug e ns ns tUse it uin ut g e A a ft (E na eB r RI ly Ases. d ). op Ytou Fi ion o na ml af a y 2006 1,050 2,100 2,700 5,450 5,250 10,500 700 ( liH teSA rature s) — a s the a gonly aug P et r a e os x f c -g p rie r pne e tife ora nr r D l ehe rd u g a a lth c Fc ilount ls s ta (#tus ) tha . Me t gdiv ice as indiv l condiitions duals s uc a “ h traipl s e dia ta bx a ete 1d s 1,v . 2 a ca nt nc a e gr, e.” a nd Cont 1 he 1.r 9 aibut rt *** dions iseas a er a ere e xc inc luda lude bd le . Ph.D., RxEconomics, LLC t he o a us lth condit e more inpa ions, tie Hnt SA ser pla vns ice s. re su And lted si nc in fe e ew m ee r re gm enc ery g e dnc epya r dte m pe ant rtm ve isnt its (a visind ts ra ess laoc tivia e tte o dP spe PO nding enrolle ) w es, fe ere not wer highe specia r list An HSA-eligible health plan is a health plan with a deductible of at least $1,600 for employee-only coverage and $3,200 role of the PMP HSA Y a ( m Fr ong onst H in SA a nd plaRoe n enr buc ollk e, e20 s w 19 ith no ); and he the alt h condit impact of ions de a ds c uct om ible ps on ared us wit eh P of P low O e -v nr aol lue led e s, b serv ut ic e spe s (Fr nding onst iw n, as Prescription Drugs Age (Year 1% s) -2% 3% ** -1% 1%32.2 -2% 32.5 2% *** 3% 1% 0.03% cohor cop t si yze , p s, w rinthic , or h dvow arie nloa d bd y tyhis ea rr e ap nd ortp lsolely for an type ( i.e pe., rsona therl a e w nd a s a nonc n unb omm ala enc rcia ed l use pane , pl rd ov atide aset) d t, ha ra t nge all ha d fr rd om cop 47 ie2 s ,000 reta in in Full-Replacement, Consumer-Directed Health Plan With a Health Savings Account." EBRI Notes, 35(3). 2007 1,100 2,200 2,850 5,650 5,500 11,000 800 fr Ov om era tlla , xa the ble CCI inccom urre e. ntly Dis c tr oibut nsisions ts of for 17 he qua alth lifie cd o nd miti ed oic ns a.l e Se xpe e Cha nserls s a on, nd Pc oe mp rtaein p i, Ale resm , a ium nd Mac payKe me nzi nte s a (1987) re tax fr ; De ey eo . ,A Che nd rkin, a vis mit ong s, a nd HSA fe p wla en r p ernr esc olle ripti eson , we d rc ug an conc fills. Vi lude sits t tha o p t rit im w aa ry s ne carce e ss pra ov ryide for rs inc enrolle reae sed s w . it Ih he n cont altrh condit ast, among ions etnr o olle rece eiv s w e tit he h two Notes: Presented are HDHP (vs. PPO) coefficients from linear fixed-effects models of dependent variables using the full sample, and specific cohorts as defined in column for family coverage in 202 Und 4. e rMa 18ximum out-of-pocket limits for in-netw 26 or .8k % care cannot 26.1 e %xceed *** $8,050 for employee-only Roe buck, $2 B,490 uxba um or 6 p , and erc Fe ent n d highe rick, r20 P20 MP)Y . Re am cong ent st Hudie SA ps laa n re e nr als olle o e exa s w mit ini h two ng m or or em cor ure r ehnt ea d lta h condit ta and p ions lan . eThi nrolle s highe es’ r Use of Preventive Screening Services PPOs d any ur aing nd 20 all c 21 op to yr1 ight .6 m aill nd ion ot he in r H a SA pp -e lic ligib able le not hea iclteh p s cla ont nsa in dur ed ing the 20 re18 in, . and you may cite or quote small portions of 2008 1,100 2,200 2,900 5,800 5,600 11,200 900 and Ciol (1992); and Quan et al. (2005) for more information. interest and capital gains on account balances also build up tax free. All mod els included the following covariates (if time-varying): age, male/female, region (Northeast, Midwest, South, West, other), individual/family coverage, ser or m vic or ee s t he he aylt h condit did in the ions inpa , th tie ernt e w sett ere ing. no instances of declines in health care services among those in HSA plans Findings 18–24 12.0% 11.5% *** c Fr ov onst erain, P ge aa nd ul, $1 and 6,10 M. 0 for Chr is fa top mily he c r oRoe vera bg uc ek . . H20 SA14 p. la"ns Qua mli aty y p of rov Hide ealt c h C ova er re a gA eft of er cA ed rop tain ting preav e Fu ntlliv -Re e ser plav cic em es p ent r, ior H igh to - the behaviorspe s ove ndin r long g we aB rs d rte im a riv se t e c p n b a enrc iod y e r21 s. Wh sc p reeern c ile ie nnt gthe highe re arre spe diffnding erenc e on s in r inpe asu tielt nt s a ser cr48% oss vice s. the studies, t 50% he*** consistent finding is the report provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing policyholder/spouse/dependent, household size, Charlson Comorbidity Index, depression, anxiety, deductible amount (individual or family), and coinsurance rate. 2009 1,150 2,300 A 3T ,000 A G 5L ,95A 0 N C E 5,8 00 11,600 1,000 5 25–34 13.2% 13.5% *** r eSla et eiv http e to s:P // Pw O we w nr .bolle ls.ge os. I v/cns pi/f te aa cts d, he those ets/mw ed itic h atlw -co a re or. htm mor . e health conditions experienced increases in inpatient *p<0.10For sa The , **tpis

Volume 605

Pages 17

EBRI Issue Brief

April 11, 2024

Paul Fronstin

M. Christopher Roebuck

Health