HSA shift leads to sustained reduction in health-care spending.

• Position: News & Numbers - Health savings account

A high-deductible health plan linked with health savings accounts reduced health spending initially and over a four-year period, according to new research from the Employee Benefit Research Institute. In one of the first studies of its kind, EBRI analyzed detailed claims data over a five-year period from a large Midwestern employer that adopted a high-deductible health plan with a health savings account (HSA) for all employees in place of its traditional health-care offering. EBRI found that introducing the full-replacement HSA plan (meaning it was the only type of health plan the employer offered) reduced the plan's total health care spending by 25 percent in the first year, or $527 per person in the aggregate.

Among the key findings:

* Each category of health spending experienced statistically significant reductions in the first year of the HSA plan, with the exception of spending on inpatient hospital stays. Spending on laboratory services and prescription drugs had the largest statistically significant declines, of 36 percent and 32 percent, respectively.

* However, only pharmacy and laboratory spending were statistically significantly lower throughout the entire four years after the HSA plan was adopted.

* Reductions in pharmacy spending were large and mostly sustained over the four years after the HSA was adopted. In...