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High-Deductible Health Plan, HSA Enrollment Reached 21M in 2017

High-deductible health plan and health savings account enrollment reached 21 million members in 2017 and is expected to continue to climb.

HDHP and HSA enrollment reached 21 million members.

Source: Thinkstock

By Thomas Beaton

- High-deductible health plan (HDHP) and health savings account (HSA) enrollment reached 21 million members in 2017, according to new research from AHIP.  These health plan options are expected to see continued growth in the near future.

In 2017, 45 payer organizations reported a 9.2 increase in HDHP and HSA enrollment from 2016 numbers. The increase equated to 1.7 million new HDHP/HSA members nationally.

The large employer (50 or more employees) market remains the most popular setting for HDHP and HSA enrollment, AHIP found.

Eighty-two percent of enrollment occurred in large employer settings, followed by the small-employer market (11 percent) and the individual market (7 percent).

The team observed that a substantial portion of HDHP enrollment consisted of older and middle-aged adults.

Thirty-three percent of HDHP and HSA enrollees were between 45 and 64 years old and 33 percent of enrollees were between 25 and 44. Enrollees 17 years old and younger accounted for 23 percent of HDHP and HSA enrollment. Beneficiaries between 18-24 years old accounted for 11 percent of enrollment.

AHIP suggested that older working adults are using HDHPs and their HSAs to plan for retirement.

“With a majority of enrollees decades away from retirement, these accounts serve as tax advantaged savings tools to prepare for medical costs during retirement,” AHIP asserted.

Many payers are capitalizing on the opportunity to use financial planning and decision support tools to engage people with HSAs and HDHPs.

Eighty-eight percent of payers allow beneficiaries to manage their HSA information and 82 percent of payers provide members with healthcare cost information.

Payers also provide HDHP enrollees with quality data on providers to help members choose the best possible healthcare options.

Seventy-percent of payers shared hospital quality data with HDHP enrollees and 69 percent shared provider quality data.

“In addition, 64 percent of respondents gave enrollees access to broker consultations and 59 percent employed a health advocate,” AHIP found.

 AHIP hypothesized that changing consumer attitudes in the health insurance market are driving significant growth in the HDHP and HSA market.

The group believes that payers are increasing their ability to give consumers affordable health plan options that can help members manage chronic diseases.

“Health insurance providers recognize that most Americans have at least one chronic illness and the importance of treating conditions early and consistently to avoid harmful and costly complications down the road,” AHIP stressed.

The researchers added that newly proposed federal policies are needed to help payers strengthen the quality of HDHPs and HSAs for their members to address current healthcare challenges.

AHIP advised policymakers to move forward with two bills introduced the House in 2018.

The Chronic Disease Management Act and the Bipartisan HSA Improvements Act would allow payers to add more preventive care benefits to HDHPs and allow consumers to increase financial contributions to their HSA.

“Additional changes to HSA account and plan rules can lower costs and enable more choice, control, and greater flexibility for millions of consumers,” AHIP concluded.

“With nearly 21.8 million lives covered in HSA-qualified plans, and enrollment expected to continue in the coming years, HSAs and HSA-qualified plans represent a vital option to provide Americans with greater control and choice over their health and financial security, leading to greater peace of mind.”


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