HealthBeat FYI: HSAs Growing, Enabling Access to Quality and Price Information

April 04, 2007

As you know, President Bush touted Health Savings Accounts (HSAs) yesterday, citing data from a recent survey by America's Health Insurance Plans (AHIP).  The AHIP census found there are now 4.5 million HSAs -- a 43 percent increase over the past year. 

What was under-reported is that while patients, employers and government all are currently clamoring for price and quality information in the overall health marketplace, most HSA plan enrollees already have it. According to the AHIP survey:

• 90 percent have access to online account information;
• 95 percent have access to online health education tools;
• 88 percent have access to health care cost information;
• 85 percent have access to hospital-specific quality information;
• 50 percent have access to physician-specific quality information; and
• 70 percent have access to electronic personal health records.

These findings confirm the analysis of a recent NCPA report that noted price and quality information are not readily available in our traditional health care market because of the way we pay for health care.  In our third-party payer system, contracts and prices are imposed by large impersonal bureaucracies.  The individual provider has virtually no opportunity to offer a different bundle of services for a different price, and no incentive to compete for patients based on price or quality.  Therefore, patients miss out on many key services, including:

• Integrated Care:  Doctors offer fragmented services to diabetics, for example, but no one offers diabetic care as such - taking responsibility for the treatment of a patient's case from beginning to end.
• Patient Education:  Diabetics, asthmatics and other patients with chronic conditions could manage much of their own care, if someone taught them how to do it.
• Telephone and E-Mail Consultations:  Potentially, the chronically ill could have more care, better care and less-costly care through modern communication devices - but few doctors consult by phone, and only one-in-four uses e-mail.
• Electronic Medical Records:  Despite studies showing that electronic medical records can reduce costs and improve quality (by reducing errors, for example), only one-in-five physicians stores medical records electronically.

The increase in HSAs and patient-controlled money is changing the health care playing field. In a health care market where patients are increasingly able to spend their own money, they are also able to make demands for higher quality and lower prices.

Read the full study The Market for Medical Care: Why You Don't Know the Price; Why You Don't Know about Quality; And What Can Be Done about It

http://www.ncpa.org/pub/st/st296/