Health Plan Design Challenges and the Impact of HSAs on Healthcare Use

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Paul Fronstin, director of Health Benefits Research at EBRI, spoke with MHE about the challenges employers face in incentivizing high-value healthcare while managing costs.

Managed Healthcare Executive editors connected with Paul Fronstin, director of Health Benefits Research at EBRI, to discuss trends in health plan benefit design and the role of high-deductible health plans and HSAs.

Fronstin addressed that employers face challenges in incentivizing high-value healthcare while managing costs.

For example, the IRS's 2019 decision to allow certain preventive services such as insulin to be covered before deductibles saw 75% of employers quickly adopting at least one of these services.

Fronstin noted that "employers would like to figure out a way to incentivize the use of high-value providers...but haven’t quite gotten it right yet.”

On HSAs, he compared the difference between their impact and that of deductibles, highlighting that higher deductibles initially reduce healthcare utilization, but over time are stable.

In addition, Fronstin talked about HSAs as savings compared to spending accounts.

Despite their potential for long-term savings, many people use them to cover current healthcare costs.

He added that recent studies have shown a slight increase in medication adherence when certain drugs were removed from deductibles, supporting the importance of accessible preventive care.

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