A recent EBRI report found that health savings account (HSA) plans have mixed effects on use of health care services. In fact, inpatient admissions and days were higher in HSA plans than in preferred provider organizations (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. This Fast Fact reviews these and other HSA usage trends.
Other Key Findings From the Report: • Office visits shifted from specialist visits to primary care visits among HSA plan enrollees. June 6, 2024, #506 • 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 HSAs Reduce Use of Outpatient Services and no health conditions, HSA plans resulted in fewer emergency department visits relative to PPO enrollees, fewer Prescr specialist viiptio sits, and f n ewer p Dru rescr gs ipti,on d Incre rug fills,ase while U visise ts to pr of im I arnpatient y care providers increased. In contrast, among enrollees with two or more health conditions, there were no instances of decline in Services; Overall Spending Unaffected 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 It appears that deductibles have been falling in both real and nominal dollars in health savings account (HSA) visits. 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 • Overall, HSA plan enrollment had no impact on total spending — there was no statistically significant plans and PPOs. While a gap remains, the movement of PPO deductibles toward HSA plan deductibles raises a difference in overall spending between HSA plan and PPO enrollees. However, spending was $60.30 or 2 question as to whether differences in deductibles are less of a distinguishing factor when it comes to managing percent lower per member per year among HSA plan enrollees with no health conditions as compared health care use by type of health plan. If that is the case, it is important to understand whether the HSA impacts with PPO enrollees, but spending was $2,490 or 6 percent higher per member per year among HSA plan use of health care services and overall spending. A recent Employee Benefit Research Institute (EBRI) report enrollees with two or more health conditions. This higher spending was driven by 21 percent higher found that HSA plans have mixed effects on use of health care services. Inpatient admissions and days were spending on inpatient services. 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. About EBRI: The Employee Benefit Research Institute is a private, nonpartisan, and nonprofit research institute based in Washington, D.C., that focuses on health, savings, retirement, and economic security issues. EBRI does not lobby and does not take policy positions. The work of EBRI is made possible by funding from its members and sponsors, which include a broad range of public and private organizations. For more information, visit Figure 1 www.ebri.org. Deductibles, Employee-Only Coverage, by Plan Type, 2013 –2020 A Thank You to Our Funders: This study was conducted through the EBRI Center for Research on Health HMO/EPO PPO/POS HRA HSA Plan $4,000 Benefits Innovation (EBRI CRHBI), with the funding support of the following organizations: Aon, Blue Cross Blue Shield Association, ICUBA, JP Morgan Chase, and PhRMA. $3,500 $3,346 $3,314 $3,308 $3,011 $2,898 $2,866 $2,869 $3,000 $2,777 ### $2,625 $2,500 $2,228 $2,202 $2,064 $2,070 $1,995 $1,975 $1,956 $2,000 $1,500 $1,222 $1,179 $1,096 $1,029 $1,043 $1,044 $987 $952 $1,000 $829 $824 $785 $769 $762 $747 $500 $654 $521 $0 2013 2014 2015 2016 2017 2018 2019 2020 Source: Employee Benefit Research Institute estimates based on administrative enrollment data. Note: Deductibles are adjusted for inflation and are in 2020 dollars. EBRI on Twitter @EBRI or twitter.com/EBRI LinkedIn: linkedin.com/company/employee-benefit-research-institute EBRI on Twitter: @EBRI or twitter.com/EBRI LinkedIn: linkedin.com/company/employee-benefit-research-institute © 2024, Employee Benefit Research Institute, 901 D St. SW, Suite 802, Washington, DC 20024, 202/659-0670 | ebri.org 2