EBRI Finds HSA Shift Leads to Sustained Reduction in Health Care Spending

A high-deductible health plan linked with health savings accounts reduced health spending initially, and over a four year period, according to a new issue brief by EBRI: “Health Care Spending after Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A Five-Year Study.”

EBRI analyzed detailed claims data over a five-year period from a large employer that adopted a high-deductible health plan with a HSA for all employees in place of its traditional health care offering. EBRI found that introducing the full-replacement HSA plan (meaning it was the only type of health plan the employer offered) reduced the plan’s total health care spending by 25 percent in the first year, or $527 per person in the aggregate.

EBRI noted that each category of health spending experienced statistically significant reductions in the first year of the HSA plan with the exception of spending on inpatient hospital stays. Spending on laboratory services and prescription drugs had the largest statistically significant declines (36 percent and 32 percent, respectively), according to the brief. The report also found, however, that only pharmacy and laboratory spending were statistically significantly lower throughout the entire four years after the HSA plan was adopted.

The EBRI Issue Brief is available here.