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High Deductible Health Plans and HSAs: Motivating Participants To Think Like Consumers

Health savings accounts (HSAs) continue to grow in popularity. For many employers and employees, it’s not a question of if they should have an HSA or not, it’s a question of when they’ll make the move. And the rationale for adopting an HSA is becoming stronger every day. A recent survey 1 by the Employee Benefit Research Institute and Anne Elmlinger, Greenwald & Associates indicates that HSAs might not only be a cost-saving vehicle, but may also help employees become healthier.

This study, now in its 11th year, indicated that employees enrolled in a high deductible health plan were more likely to act like consumers. They more frequently checked plan coverage, asked about generic medications, and discussed treatment options and alternatives with their physicians. They also participated in more wellness programs, health assessments, screening programs, and were more engaged with their overall healthcare than those in a traditional plan.

The 2016 survey also pointed out some opportunities for even more progress. Roughly 25% of those who were eligible to open an HSA had not. The survey also suggested that if we as employers and HSA providers did a better job of educating employees, there may be an increase in the frequency of choosing the high deductible, consumer-driven health plan. Roughly 30% of those with the consumer-driven health plan even admitted they were not as familiar with the plan as they needed to be.

The study showed that employers can maximize the benefits of the consumer-driven health plan with just a few changes. First, they need to coordinate and integrate the HSA with their wellness programs. Employees are most often motivated to participate in wellness programs by a desire to improve their health and by financial incentives. Second, they should make the employee’s portion of the premium lower for the consumer-driven health plan than for competing plans offered by the employer. Next, employers need to make a contribution to their employees’ HSAs. The survey indicated that a significant percentage of employers are contributing to the HSA and that the dollar amount of the contribution is rising in an effort to make the HSA a more viable choice. And lastly, employers need to provide education about the high deductible health plan and the benefits of the HSA on an ongoing basis. Employees have consistently reported that they don’t fully understand their health plans and our experience has shown that an ongoing healthcare education campaign can pay big dividends for employees and employers alike.


  1. Paul Fronstin and Anne Elmlinger. “Consumer Engagement in Health Care: Findings from the 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey.” EBRI Issue Brief, no. 433 (May 25, 2017).

Author: James Denison