While health savings accounts and consumer driven health plans demonstrably give consumers more control over their use of health insurance dollars, they may also encourage decisions about health care that could be detrimental to consumers' long-term health.
A study of 18,000 employees with a company that switched from a traditional health plan to a CDHP/HSA model found that plan members weren't taking advantage of preventative health options, and instead postponing some medical care.
The study comes from the Employee Benefit Research Institute. It reviewed use data from the plan members over five years — the first year was prior to the switch to the CDHP/HSA model. Data was contrasted with that derived from a control group coverage group of more than 82,000 members insured via a traditional PPO.
Recommended For You
While many aspects of use failed to emerge as clear patterns, the one that did was concerning.
"The introduction of the HSA-eligible health plan had a negative impact on office visits for annual physicals, well-child visits, and preventive visits in the year that the plan was adopted," EBRI reported. "In the second year, office visits increased for HSA-eligible health plan enrollees, but were mostly unchanged for the comparison group. By the fourth year in the HSA-eligible health plan, office visits for annual physicals, well-child visits, and preventive visits were down slightly relative to the comparison group.
"The introduction of the HSA-eligible health plan had a negative effect on medication monitoring for adults on select maintenance drugs not only in the first year that the new health plan was introduced, but in the following three years as well."
In addition, plan members tended to turn to antibiotics and MRIs more frequently than the control group. "Both services are often considered unnecessary," researchers said.
Breast cancer screenings increased among the CDHP/HSA group over time, while cervical and colorectal cancer screenings were lower within that group than in the control group with the PPO.
EBRI noted that the study offered a rare opportunity to compare large amounts of health service use data for a large employer group that had been entirely moved from a traditional plan to one with the HSA options.
"This study adds to the literature on consumer-driven health plans (CDHPs) by examining use of health care services used to measure quality of health plans during the four years after a health savings account (HSA)-eligible health plan was adopted. As with prior research examined, the findings are mixed," EBRI said.
- Consumers getting a handle on HSAs
- IRS announces 2015 HSA limits
- HSA holders worried PPACA will take away control
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
