Health Savings Accounts and related high-deductible plans continue to nibble away at traditional health-care alternatives, such as HMO and PPO plans, as employers rebel against rising premium costs.

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But so far, the inroads appear to be incremental, even though the availability of options is growing rapidly...

HSAs, the health-care equivalent of 401(k) accounts, are typically packaged with high-deductible insurance plans. Proponents say they have the potential to encourage health-care consumers to act like consumers usually do, comparing prices and making rational economic decisions. Critics say HSAs shift too much financial burden from employers to employees without providing adequate tools and information -- and may end up draining resources from the pooled insurance funds that allow the entire system to work...

The reason: Many employers have raised deductibles and co-pays, but realize "they're running out of room for that (approach)," Smith said. "You can only push so far, and members start dropping out of the program."

Although Blue Cross and Blue Shield have jumped into the new arena quickly, rivals like Health Net and PacifiCare "lag significantly," according to Tellez.

Kaiser officials have pushed back plans to introduce HSAs in California, saying they'll do so next spring after piloting the new plans in Colorado, Georgia and the Pacific Northwest. Sign-ups in California for a new HRA or health retirement account will start in early October, with coverage to begin in January. Kaiser has about 57,000 California members in several deductible plans introduced this year, another departure for the huge HMO. "We're probably at the front end of a very rapid growth phase," said Ted Wise, Kaiser's senior vice president for national product development.

Even so, Wise said, Kaiser's traditional HMO plan "is still where the vast majority of our members are."

Among them, those five health plans -- Kaiser, Blue Cross, Blue Shield, Health Net and PacifiCare -- hold about 80 percent of the California commercial health plan market. And experts like Henry Loubet, senior vice president and chief strategy officer at Keenan, a statewide brokerage firm, guesstimate that only about 300,000 Californians have enrolled in these plans. That compares with an estimated 2 million nationwide -- a drop in the bucket compared with traditional HMO and PPO plans.

Still, employers want to hear more about these new offerings.

At Blue Shield, membership in plans including HSAs, HRAs, high-deductible or consumer-directed plans is at about 130,000 statewide, up from about 105,000 in January. "And I would expect it to pick up. As we offer more tools (such as price and quality comparisons for various doctors and hospitals), we'll see even more adoption," said Michael Israelite, the company's senior director of product and marketing....


Source: MLive.com