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Health Plans Brace for HSA, HRA Headaches

Margaret Dick, for HealthLeaders Media, March 2, 2011

The leveling of account balances and the absence of cost conscious behaviors may add up to a big headache for health plans.

“They (health plans) should be concerned,” said Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report. “Are their members building up account balances or not? Are they covering their deductibles and out-of-pocket expenses? If not, what does that mean for the long term?”

This could be a big worry in treating people with costly chronic diseases. If those members do not maintain adequate account balances to cover their deductibles and out of pocket treatments then their health could suffer over time. (ERBI research indicates that account balances for people with chronic diseases tends to be lower than of those without such health problems.)

Fronstin says more research is needed to identify what may be affecting balances. He is quick to point out that the mechanics of HSAs make it impossible for health plans to monitor account balances. So studies like this one from the ERBI offer important insights.

Plus, even with rollovers, according to the research, it takes around three or four years for account balances to exceed $2,000. Also, HSAs and HRAs are very new and consumers may still be figuring out how to use them.

And the recent economic downturn could be playing a role in the decline of account balances.

Health plans can take comfort in at least two report findings: people who used on-line cost tracking tools supplied by their health plans maintained slightly higher account balances in 2010 than those who did not and account holders who checked the quality rating of a physician or hospital also enjoyed higher balances. That could indicate that consumers are more willing to take cost into consideration when a large amount of money is at stake.

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