At a Glance | June 13, 2019 Larger HSA Balances Result in Increased Use of Health Care Services and Spending HSA TRENDS Average HSA Balance at Percentage of HSAs With Zero Beginning of Year After Two Balance at Beginning of Year The average HSA balance more Years of Contributions After Two Years of Contributions than doubled between 2014 2014–2016 2014–2016 and 2016 among enrollees $2.9k $ 3 k 25 % with employee-only coverage. 20% The percentage of accounts $2.0k with no balance at the beginning of the year fell $1.1k considerably after two years of contributions. Only 2 percent of HSAs started 2016 with a 3% 2% zero balance. $0 0% 2014 2015 2016 2014 2015 2016 HEALTH CARE SERVICES USAGE Spending Impact of a Beginning-of-Year HSA Balance of $3,000 or More Individuals with $3,000 or more Change in Use of Health Care Services in their HSA at the beginning for Every 100 Enrollees, 2016 Spending of the year made an additional Reduction Increase Impact 50 visits to primary care ••••••••••••••••••••• +21 $20 Primary care physician visits physicians and specialists per 100 plan enrollees. •••••••••••••••••••••••••••••+29 $28 Specialist visits ••••••••••• +11 $9 X-rays Their spending was about $20 higher for primary care ••• +3 $17 CT scans office visits and $28 higher ••••••••• +9 $1 Blood test, panel for specialist visits. Spending +2 associated with outpatient •• $8 EKG, echocardiogram, stress test services was $551 higher. +2 •• $35 MRI +1 • $83 Inpatient services, prescription Musculoskeletal surgery drug fills, and radiology related $551 Outpatient costs NA to cardiovascular disease were not affected by HSA balances. Source: Paul Fronstin and M. Christopher Roebuck. “Do Accumulating HSA Balances Affect Use of Health Care Services and Spending?” EBRI Issue Brief, no. 482 (Employee Benefit Research Institute, May 23, 2019). © 2019 EBRI This report is copyrighted by the Employee Benefit Research Institute (EBRI). You may copy, print, or download this report solely for personal and noncommercial use, provided that all hard copies retain any and all copyright and other applicable notices contained therein, and you may cite or quote small portions of the report provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing requires EBRI’s prior express permission. For permissions, please contact EBRI at permissions@ebri.org.