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5 Ways that HSAs Help Make Us Smarter Healthcare Consumers

High Deductible Health Plans (HDHPs) are here to stay. Fifty-eight percent of companies with more than 200 employees offer HDHP plans, and the average family deductible for HDHP plans is $4,676. Among adults with employment-based coverage, the percentage enrolled in a traditional health plan decreased from 85.1% in 2007 to 56.6% in 2017. A large portion of that difference lies in people choosing HDHPs.

For many, the HDHP seems like a cost-sharing tactic but over time, consumers have grown to appreciate the value and flexibility this type of plan can deliver — especially when paired with a Health Savings Account (HSA). HSAs are an ideal way to pay tax-free for medical expenses today and can also provide an excellent safety net for future expenses and retirement.

With the added autonomy and financial accountability of HDHPs with HSAs, employees are being increasingly pushed to take greater control of their own healthcare. Here are five of the ways that HSAs make us smarter healthcare consumers.

1) HSAs encourage consumers to “shop around” for healthcare.
Since HSAs started to become a more popular employee benefit offering in the mid-2000s, one of the most important educational challenges for employee benefits professionals has been helping employees understand the areas in which they can — and should — take more control of their own healthcare choices (and consequentially, their budgets).

A recent study shows that online comparison shopping for healthcare services has increased 25% over the past five years – partially due to greater online access but also due to the nature of today’s health plans. In fact, 51% of millennials today shop for healthcare services online (and 36% of all study respondents).

As individuals become more accustomed to the way HSAs and HDHPs work, they are becoming more selective when it comes to paying for services — and that’s good news. Over time, this will have a positive impact on the overall cost of healthcare for employers — as well the average consumer’s pocketbook.

2) HSAs encourage smarter, more efficient healthcare choices.
The use of HSAs and greater consumer autonomy over their own healthcare bills is pushing more people to more critically evaluate things like prescription drug choices — and ask more questions of their prescribing doctors. While the generic versions of prescription drugs are often less expensive, many consumers have had long-standing allegiance to brand names. For most people, generic drugs are a perfectly suitable choice, and an obvious place where consumers can impact their own bottom line.

A cohort study conducted by Blue Cross Blue Shield of Illinois on behalf of Conduent revealed that, within three years of shifting from a traditional PPO to an HDSP/HSA plan, there was an 8.3% drop in ER visits, hospital admissions dropped by 21.7% and overall medical costs went down by 9.2%. In many ways, these transformative statistics can be attributed to a series of individual choices that each healthcare consumer makes over time.

Through the independence HSAs afford, health plan participants are gaining greater control of their healthcare and their personal budgets as well.

3) HSAs have driven consumer demand for increased transparency in healthcare treatment and costs.
People who are used to having traditional healthcare coverage through their employers have been conditioned to simply accept what’s covered vs. what’s not, or what’s out of network and what’s not. But many don’t even realize the amount of choice and flexibility that’s now available through an HDHP combined with an HSA. As individuals become more accustomed to the way these plans work, they are becoming more selective when it comes to paying for services — and that’s good news. So instead of simply “following doctor’s orders” (which is often a good practice, by the way), patients are taking more initiative in asking questions about the treatments, medicines and surgeries they need, as well as the options for consuming them in terms of in-patient vs. outpatient, primary doctor vs. specialist, etc.

This doesn’t mean that consumers can always “have healthcare their way,” but by becoming more engaged in their healthcare options and treatment plans, they’ll put themselves in a better position to receive the most appropriate treatments — and not as many surprise bills in the mail after the fact.

4) HSAs support the movement toward greater personal health awareness.
In an age of wearables, smart watches, clean eating and organic everything, more people than ever before are taking a greater interest in their own personal healthcare. There are several ways that participation in an HSA with a HDHP encourages self-awareness and wellness practices.

One way is through company-sponsored biometric screening and healthy choices programs whereby employees are given HSA contributions for participating. Another example is where employers give discounts and other perks for good scores (or improving scores) and for lifestyle choices such as quitting smoking or acquiring a gym membership. HSAs also support the individual’s focus on healthy living through the reimbursement of things like dietary supplements, weight loss program fees, and health-related education classes (depending on the plan details).

5) HSAs have pushed consumers to demand more individualized, intuitive, self-service interactions.
Though mobile access and digital channels continue to gain popularity for doing everything in our lives, these channels are particularly convenient for consumer healthcare engagement. Whether plan participants are comparing the costs of prescription drug prices, searching online for in-network doctors paying a bill via their mobile phone, they expect to be able to access their own personal health information and plan specifics anytime, anywhere.

That’s why HSA administrators such as Conduent’s BenefitWallet® are constantly working to improve those digital experiences and create an ongoing dialogue of interactions that feel personal to each individual along every step of the healthcare continuum.


Over the past decade, the US healthcare landscape has dramatically shifted in many different ways including the types of health plans available to people, the way consumers view plan options, how insurance providers approach covered services and facilities, and how providers approach care (just to name a few). Navigating this new landscape can be tricky — but today’s consumers are catching up. For HSA participants, this means taking a more active role in every aspect of their healthcare — doing the research, asking the right questions, demanding omnichannel interactions and getting smarter every step of the way.


About the Author

Arjun Sandhu is a recognized expert, speaker on consumer-directed health accounts. As the Portfolio Leader of BenefitWallet® within Conduent Human Capital Solutions, Arjun helps employers, consumers, consultants, and carriers unleash the power of HSAs, FSAs and HRAs. Arjun is a board member of the American Bankers Association HSA Council, and a council member for the Employers Council on Flexible Compensation.