title: What do health savings accounts mean for the emergency department?
abstract: The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on the adoption of these plans and their effects on use and reimbursement. Compared to many specialties, the emergency department (ED) may be insulated from extensive shopping and price negotiation, because visits to the ED are often for urgent and time-sensitive conditions. However, ED utilization patterns may change if cost-conscious health savings account holders forgo other necessary medical care, or if they seek out substitutes to the ED for less urgent problems. In the long run, the ED may feel the impact of changes that stem from 2 areas: the ability of health savings accounts to control the increase in health care costs, and the potential of health savings accounts to replace or undermine more comprehensive health insurance plans. We note areas that emergency physicians should monitor as health savings accounts become more prominent.
authors.affiliation: Center for Policy & Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA. mcconnjo@ohsu.edu
authors.forename: K John
authors.initials: KJ
authors.lastname: McConnell
mesh_terms: D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005249:Fees and Charges; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007348:Insurance, Health / Q000639:trends; D020402:Medical Savings Accounts; D010342:Patient Acceptance of Health Care; D012051:Reimbursement Mechanisms / Q000191:economics / Q000639:trends; D014481:United States