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Health Care Spending after Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A

By Five-year Study


� This study reports experience over five years from a single large employer in the Midwestern United States that adopted a high-deductible health plan with a health savings account (HSA) for all employees. This study represents one of the longest observation periods reported with a full-replacement CDHP, and it is one of the few studies with a matched control group. � In the first year of the HSA, the employer’s aggregate health care spending was reduced by $527 per person. � Results show that spending was reduced significantly in the inaugural year of the HSA plan in medical, pharmacy, and total-claims categories. Further, the magnitude of the cost savings was greatest in this first year but the cost savings continued over the succeeding three years albeit at a slower pace. � The introduction of the full-replacement HSA plan reduced total spending by 25 percent in the first year. 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). � When examining the spending components separately, only pharmacy and laboratory spending were statistically significantly lower throughout the entire four years after the HSA plan was adopted

Year: 2013
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