Many U.S. adults with private health coverage now have high-deductible health plans with no personal health accounts, according to Paul Fronstin.
Fronstin, a benefits researcher at the Employee Benefit Research Institute (EBRI), Washington, writes about people who have high-deductible health coverage but no health savings accounts (HSAs) or health reimbursement arrangements (HRAs) in an analysis of results from an online survey of 4,703 privately insured adults ages 21 to 64.
The percentage of privately insured adults with personal health accounts has increased to 7% this year, from 5% in 2010, and the percentage with high-deductible coverage has increased to 16%, from 14%, over that same period, Fronstin says.
About 6.1% of all of the survey participants said they were enrolled in high-deductible plans and had access to HSA programs but had not set up HSAs, Fronstin says.
EBRI classified a plan as having a high deductible if the individual deductible was $1,000 or higher or if the family deductible was $2,000 or higher.
The organizers of the first health account programs emphasized that the programs would promote consumerism, in part by giving enrollees more information they could use to compare the cost and quality of health care providers.
Today, health account plan enrollees were more likely than enrollees in traditional plans to say they have been asked to fill out a health risk assessment, but enrollees in all types of high-deductible plans, including health account plans, "were less likely than traditional plan enrollees to report that the plan provided cost or quality information," Fronstin says.
Enrollees in health account plans, high-deductible plans without health accounts, and traditional plans were equally likely to report using any cost or quality information that was available, but Fronstin found that the health account plan and high-deductible plan enrollees were more likely than traditional plan enrollees to take steps such as checking to see whether doctors are in network or asking for generic alternatives to name-brand drugs.
Traditional plan enrollees were more likely to say they would participate in a wellness program if they were required to do so to enrolled in a preferred health plan or get a $50 cash incentive.
Enrollees in health account plans and high-deductible plans were most likely to say they would participate in a wellness program to avoid an increase in premiums aimed at non-participants or to collect a $250 cash incentive.