A growing number of U.S. workers have so-called consumer-driven health plans through their employers. These plans feature high deductibles with either health savings or health reimbursement accounts. The theory is that people in such plans will use healthcare more prudently because they have to pay for services from their own savings accounts. But critics say they discourage people from getting appropriate as well as inappropriate care, and RAND Corp. research bears that out.
About 14.7% of the privately insured population was enrolled in a consumer-driven health plan in 2014, according to a new Consumer Engagement in Health Care Survey (PDF) by the Employee Benefit Research Institute and Greenwald & Associates. In 2014, 48% of employers with 500 or more workers offered either an HSA or HRA plan.
HSAs and HRAs contained $22.1 billion in 10.6 million accounts in 2014, up from $5.7 billion in 4.2 million accounts in 2008. The average account balance last year was $2,077, up from $1,356 in 2008.
People who had an HSA or HRA for five years or more had $3,092 in their account, while those who had an account for less than a year had a balance under $1,500. Accounts with an employer contribution had a higher average balance than those without an employer contribution. But nearly a third of employers make no contribution to employees' accounts, according to the Kaiser Family Foundation.
The EBRI/Greenwald report said account balances currently are “low,” raising questions about whether these savings accounts are sufficient to make healthcare affordable for employees in plans with high deductibles and coinsurance.
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