Ann Emerg Med. 2005 Dec;46(6):536-40. Epub 2005 Jul 1.
What do health savings accounts mean for the
emergency department?
McConnell KJ.
Center for Policy & Research in Emergency Medicine,
Department of Emergency Medicine, Oregon Health & Science
University
The insurance market is evolving, with increased emphasis
on plans with high deductibles and a large degree of coinsurance.
This article serves as an introduction to the defining characteristics
of consumer-driven health care plans and their associated
health savings accounts. We discuss the most recent evidence
on the adoption of these plans and their effects on use and
reimbursement. Compared to many specialties, the emergency
department (ED) may be insulated from extensive shopping and
price negotiation, because visits to the ED are often for
urgent and time-sensitive conditions. However, ED utilization
patterns may change if cost-conscious health savings account
holders forgo other necessary medical care, or if they seek
out substitutes to the ED for less urgent problems. In the
long run, the ED may feel the impact of changes that stem
from 2 areas: the ability of health savings accounts to control
the increase in health care costs, and the potential of health
savings accounts to replace or undermine more comprehensive
health insurance plans. We note areas that emergency physicians
should monitor as health savings accounts become more prominent.
