Health savings accounts and health care spending.
OBJECTIVE
The impact of consumer-driven health plans (CDHPs) has primarily been studied in a small number of large, self-insured employers, but this work may not generalize to the wide array of firms that make up the overall economy. The goal of our research is to examine effects of health savings accounts (HSAs) on total, medical, and pharmacy spending for a large number of small and midsized firms.


METHODS
Health plan administrative data from a national insurer were used to measure spending for 76,310 enrollees over 3 years in 709 employers. All employers began offering a HSA-eligible plan either on a full-replacement basis or alongside traditional plans in 2006 and 2007 after previously offering only traditional plans in 2005.


METHODS
We employ difference-in-differences generalized linear regression models to examine the impact of switching to HSAs. DATA EXTRACTION METHODS; Claims data were aggregated to enrollee-years.


RESULTS
For total spending, HSA enrollees spent roughly 5-7 percent less than non-HSA enrollees. For pharmacy spending, HSA enrollees spent 6-9 percent less than traditional plan enrollees. More of the spending decrease was observed in the first year of enrollment.


CONCLUSIONS
Our findings are consistent with the notion that CDHP benefit designs affect decisions that are at the discretion of the consumer, such as whether to fill or refill a prescription, but have less effect on care decisions that are more at the discretion of the provider.
Lo Sasso
Anthony T
AT
Division of Health Policy and Administration, School of Public Health, University of Illinois, 1603 W. Taylor Street, Chicago, IL 60612, USA. losasso@uic.edu
Shah
Mona
M
Frogner
Bianca K
BK
D000328:Adult; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003669:Deductibles and Coinsurance / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006279:Health Maintenance Organizations; D006801:Humans; D007342:Insurance Benefits / Q000191:economics / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D007356:Insurance, Pharmaceutical Services / Q000191:economics / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D020402:Medical Savings Accounts / Q000706:statistics & numerical data*; D011243:Preferred Provider Organizations; D055553:Prescription Drugs / Q000191:economics; D013223:Statistics as Topic; D014481:United States
D055553:Prescription Drugs