HSAs continue to see growth among patient population

About 15.5 million people were covered by health savings accounts/high-deductible health plans as of January — an increase of about 2 million from 2012, according to a June report by America’s Health Insurance Plans. Such plans have been on the rise the past five years.

About 11.4 million people were enrolled in 2011, compared with 10 million in 2010, 8 million in 2009 and 6.1 million in 2008, the report said. AHIP has been tracking such plans since they were authorized by the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

The plans are designed to give patients incentives to manage their health care costs by using savings accounts coupled with high-deductible plans. Deductibles in such plans are at least $1,200 for a single person and $2,400 for families.

Under the plans, employers regularly add money to employee health savings accounts. Employees can use this money for medical expenses when they haven’t reached their deductible amount. Money unused in a year is rolled over to the next year.

“These plans are giving consumers more control over their health care dollars,” said Clare Krusing, an AHIP spokeswoman.

HSA/HDHP plans have not been as popular with some physicians, said Cyril Chang, professor of economics and director of the Methodist Le Bonheur Center for Healthcare Economics at the University of Memphis in Tennessee. That’s because patients may not want to pay out of pocket for health care or dip into their health savings accounts set up by employers for what might be medical false alarms, Chang said.

Although the plans are designed to make patients think twice about health care costs, not going to the doctor can come back to hurt patients if they don’t seek care when they really need it, he said.

“Since you’re paying for a bigger share [of health care costs], you’re price conscious,” Chang said. “This could be a good thing, but is the employee really qualified to decide? They can be penny-wise and pound-foolish. The question is: Are they making the right choice?”

Premiums on the rise

Chang said employers are turning to HSA/HDHP plans because insurance premiums are rising, and they want to control expenditures and ensure their costs are more predictable from year to year.

Premiums for a family of four increased an average of 4% in 2012 for those with employer-sponsored coverage. The single coverage rate went up 3%, according to a 2012 survey by the Kaiser Family Foundation and the Health Research & Educational Trust.

That report also noted that while worker earnings grew 47% from 1999 to 2012, premiums jumped 172%. The employee contribution to premiums grew 180%.

In 2012, the premium contribution for a family of four working at a company of three to 199 staffers was $5,134, up from $1,831 in 1999. Workers at companies with 200 or more employees paid $3,926, compared with $1,398 in 1999.