HSA Best Practices to Boost Program Success in a Post-ACA World
Published on October 11th, 2016
The passage and implementation of the Affordable Care Act (ACA) have brought with it many sweeping changes to the healthcare industry and have caused many employers to take a fresh look at the way they offer healthcare benefits. Insurance market reforms – such as the establishment of public exchanges, expanded coverage mandates, and quality and value incentives – continue to drive employers and consumers toward adoption of high deductible health plans (HDHP) and complementary health savings accounts (HSAs).
Prior to the major rollout of the Affordable Care Act in 2013, HSAs were already growing at a steady pace. But now, as many provisions of the ACA have become entrenched in the healthcare marketplace, new opportunities to ramp up HSA program success have come into play. Let’s look at five ways you can leverage ACA provisions to boost your HSA program’s success.
1. Provide a clear path into a consumer-centric “retail” model.
With the introduction of public exchanges, and the increasing number of employers shifting their benefits model from defined benefits to private exchanges and defined contribution, consumers need an unparalleled level of savvy to navigate the healthcare marketplace. More than ever before, consumers are enrolling in HDHP plans and, as a result, need to plan and manage their short and long-term healthcare expenses. This precipitates the need for cost transparency and a high level of quality to deliver the greatest value.
In the older defined benefit model, healthcare was packaged and presented like a gift box. In comparison, today’s defined contribution model is more like receiving a gift card with which employees get to shop for plans that best suit their unique needs. In order to guide consumers through this paradigm shift and, at the same time, increase HSA adoption, we must help consumers make better purchasing decisions throughout the buying process.
As with any retail buying decision, there are various points along the path from shopping to consuming where health plans, TPAs and employers can provide tools and information that result in the lowest-cost, highest-value plan, with dollars left over to invest for out-of-pocket expenses. Education and decision support tools are crucial at the “kicking tires” stage. Further along the decision-making process, tools that help consumers project expenses, budget and comparison shop will help move them even further down the path. Finally, incentives that continue to build conscientious healthcare consumers, such as wellness and preventive care incentives, employer contributions to HSAs and incentives for choosing generics, for example, can all lead to surplus dollars from healthcare savings that can be invested in HSAs.
2. Communicate year-round to educate & guide the consumer to greater responsibility & accountability.
With great power comes great responsibility. More choices in the marketplace – resulting from public and private exchanges, tax implications and less employer involvement in healthcare decision-making – can overwhelm consumers who never had to think much past which of two or three employer-defined plans to choose.
Information about plan, account features and benefits trickles down from the plan administrator to an employer group and then to human resources who finally communicates with individual consumers. Like any complex concept, much gets lost in the translation and the top of the communication funnel believes they are communicating much better than those being fed information at the bottom of the funnel.
The key, of course, is education, education, education! If employers simply distribute booklets of overwhelming information during open enrollment, they can expect low participation. A more successful strategy is to provide information throughout the year through multiple channels. In addition to open enrollment materials, offer webinars, lunch and learns, on-demand video, displays, and dedicated Intranet pages. And, importantly, information should be available and reinforced throughout the year – not just during open enrollment when people tend to be busiest and are pressured by enrollment deadlines.
3. Make it easy to enroll, fund and manage HSA accounts.
Participants, employers, health plans and TPAs all have different needs, but in general, in order to ensure program success, you should “iron out” every possible sticking point.
- Online enrollment: Integrated disclosures and funding is a must
- Mobile access: Consumers need to access funds and see balances in real time whenever and wherever they are
- Alerts & notifications: Engaging consumer at the right time with the right information will impact consumer confidence and empower them to engage with their HSA and CDH accounts
- Integrated claims information: In true CDH fashion, let consumers decide how and when to pay
- Simplified enrollment administration with minimized risk
- ACH funding of HSAs
- Aggregate outcome-based reporting
- Payroll integration for HSA funding
- Self-service account maintenance
Health plan and third-party administrative solutions should include best practice capabilities that:
- Integrate all CDH accounts, from FSA and HRAs to HSAs and more
- Provide the ability to service accounts
- Enable single sign-on to make working in multiple, non-integrated systems easier
- Offer multiple HSA partners. Consumers and employers may appreciate the ability to work with a financial institution in their own region and based on their unique organizational structure
- Allow them to promote their own product through a branded online and mobile portal
4. Offer integrated, multi-channel self-service options wherever possible
As the industry continues to work toward changing the way consumers view healthcare costs and savings, it’s essential that they have easy access to information that helps them make better decisions and manage their healthcare dollars, wherever and whenever they want.
Integrated, multi-channel self-service tools should mirror mobile banking applications. An ideal app integrates claim and health plan information and allows consumers to enroll, submit claims, access documentation and training, provides information management, transaction history, and allows for deposits and payments. Likewise, employers should be able to create profile-based permissions and view/manage payroll contributions through a customized interface, as well as be able to add and delete plan participants.
While many provisions of the ACA have been steadily introduced to the public over the last few years, with another major one – the “Cadillac tax” – yet to come, health plans, TPAs and employers have a great amount of power to help consumers understand the benefits and value of HSAs. By leveraging education, decision support, preventive care, incentives and cost transparency, the industry can make major inroads into helping consumers drive down healthcare costs and move them toward investing in HSAs to fund short and long-term healthcare expenses.