Medicare Compliance & Reimbursement

AHA and FAH say consumer-driven plan members will be equal.

Participants in so-called consumer-driven health plans need not fear that they will be second-class citizens at the nation's hospitals.

That was one key message of a survey released April 20 by the American Hospital Association and the Federation of American Hospitals, which represent not-for-profit and for-profit hospitals, respectively.

Specifically, the survey found that virtually all (95 percent) of enrollees in health savings accounts and health reimbursement arrangements enjoy the benefit of the offering insurer's provider networks and negotiated discounts. 
 
FAH President Chip Kahn declared in a statement, "These survey results should dispel the myth that consumers with HSA and HRA-type coverage will be treated differently by hospitals than those who are members of HMOs or who have traditional health insurance."

HRAs are employer-funded accounts that employees generally forfeit if they leave the company.

HSAs are portable accounts, used in conjunction with high-deductible insurance policies, that allow employer and employee contributions; contributions come out of pre-tax dollars for the employee, contributions accumulate tax-free, and withdrawals are tax-tree if used for health care expenses. According to the AHA-FAH survey, 56 percent of health plans offering HRAs and HSAs arm enrollees with comparative cost information about hospitals and/or providers, while almost half offer comparative qualify information, mostly about hospitals.
 
However, only 13 percent of plans that offer comparative cost information - and a third of the plans that offer comparative quality information - adjust by severity
of illness.

Some Researchers Aren't So Sure

The survey describes a vigorous and growing market for consumer-driven plans. However, another analysis released April 20 argues that HSAs are likely to do more harm than good.
 
Columbia University's Sherry Glied and Dahlia Remler conclude that, for uninsured people, the tax advantages associated with HSAs would be worth only 0 percent to 6 percent of a typical premium for a high-deductible policy. Moreover, they say, "high-deductible coverage is likely to be much less valuable to uninsured people than more generous standard coverage."