- Health data company Amino is making a new play, with the launch of a health savings account (HSA).
- CEO David Vivero told Healthcare Dive the effort comes at a time when individuals are increasingly exposed to financial risk in healthcare. Consumers "have high deductibles and there's no turning back," Vivero said.
- Available to employers this spring, the company plans to roll out the offering to individuals insured through the Affordable Care Act's marketplace later in the year.
High deductibles are rising while HSAs are being underutilized. Amino is hoping the former trend will fuel interest in its HSA.
The average deductible for those with employer-based health insurance increased from $303 in 2006 to $1,505 in 2017, according to a recent Kaiser Family Foundation report. This rise comes in tandem with out-of-pocket healthcare spending outpacing wage growth and healthcare cost increases exceeding the U.S. economy's growth.
These forces put patients in a bind. A recent JPMorgan Chase Institute report found families are delaying healthcare payments until they get more “liquid assets.”
That's where HSAs, which have been around for years, could come in.
Individuals contribute money on a pre-tax basis to these savings accounts. The funds roll over year-over-year and can be used to pay for qualified medical expenses. More than 20 million Americans currently use HSAs, and millions more are eligible because of their high deductible plans. These plans are becoming more common through employer-sponsored insurance and the marketplace; nearly 40% of Americans were on high deductible plans in 2016, up from 26% in 2011, according to the CDC.
HSAs may be the most useful for a cost-conscious consumer, but therein lies the dilemma: Prices for most healthcare services are opaque and Americans generally aren't asking providers about healthcare price information. Moreover, HSAs are underutilized.
Nearly half (43%) of employees enrolled in HSAs in 2017 did not contribute any of their money into the accounts, according to Willis Towers Watson.
Vivero believes the low HSA use can be overcome with better education and design. "By marrying the HSA with a built concierge [offering], people can take away benefits of the care plan they have," he told Healthcare Dive.
Features will include personalized goals and educational content and information centered around in-network status, cost estimates and quality measures.
The product and a rise in card-carrying HSA members attempts to capitalize on a buzzword circling the industry: consumerism.
High deductibles are nudging individuals to think about the cost of and where they receive care. While it may not be a full-blown mainstream movement yet, there are some encouraging findings. For example, those using consumer-driven health plans (CDHPs) — which includes HSAs, health reimbursement accounts and flexible spending accounts — were more likely to say that they had checked whether the plan would cover care (54% CDHP vs. 44% traditional) and that they had used an online cost-tracking tool provided by the health plan (31% CDHP vs. 20% traditional).
Vivero is counting on these trends to continue. "We are in a no-turning-back-state around consumerism. It's not going to change," he said. He added it's yet to be seen where events settle with how much financial risk individuals are comfortable taking on.
High deductibles and consumerization are top of mind for hospitals and health systems. After enjoying a period of falling uncompensated care rates, bad debt increased in 2016, the first such increase in three years. About 4,000 community hospitals provided a total of $38.3 billion in uncompensated care in 2016, up from $35.7 billion in 2015.
"A new framework needs to be created before you hit a deductible," Vivero said.