Industry expert: health savings accounts engage consumers in care

OB/GYN News, May 1, 2005 by Mary Ellen Schneider

Health savings accounts and other consumer-directed insurance products can help lower health care utilization and encourage better health behaviors, according to an industry expert.

Consumers "begin to recognize that the behaviors that they have can lead to a health outcome that can actually cost them money in the long run," said Doug Kronenberg, who is chief strategy officer for Lumenos, an Alexandria, Va.-based company that sells health savings accounts.

"And therefore they begin to think about changes in their behavior that can impact that health care," he commented.

When an employer or insurer combines that with a program that also shows consumers the financial benefits of changing their behavior and offers support tools, consumers really become engaged in their health care, Mr. Kronenberg commented during a teleconference that was sponsored by the Kaiser Family Foundation.

For example, employers can create financial incentives for consumers to complete a health risk assessment.

Health savings accounts (HSAs) were authorized under the Medicare Modernization Act of 2003 and are portable accounts that consumers can use to pay for certain qualified medical expenses.

The accounts are generally offered in conjunction with a high-deductible insurance plan, and both consumers and employers can contribute to these accounts.

HSAs and similar accounts, such as health reimbursement accounts, can also create big savings for employers, Mr. Kronenberg said.

With these types of plans, consumers tend to see the money as their own, and utilization of health care services typically drops.

"That's not a bad thing, when you take a look at the environment we're in today, as long as you're getting the right kind of utilization reduction," Mr. Kronenberg said.

However, Mila Kofman, J.D., who is an assistant research professor at the Health Policy Institute at Georgetown University, Washington, commented that HSAs coupled with high-deductible plans are just shifting the cost burden for health care from the insurer and the employer to the consumer.

And one of the possible pitfalls of the plans is that consumers who are facing deductibles of $1,000 or more each year will simply forego needed medical care because they can't afford to pay for it. This could actually raise the cost of health care in general if consumers skip or delay screenings and other preventive care that can identify problems early, Ms. Kofman said.

DATA WATCH

Nearly Half of Patients Unwilling to Pay for Online Communication With
Their Physician

Unwilling to pay     44%

Would be willing to  36%
pay something

Don't know           21%

Note: Based on a nationwide survey of 2,387 adults conducted Feb. 4-8,
2005. Percentages do not add to 100% because of rounding.

Sources: Harris Interactive, Wall Street Journal Online

Note: Table made from pie chart.

BY MARY ELLEN SCHNEIDER

Senior Writer