HSAs Part of Bush’s Agenda for Healthcare

Wednesday, February 1st, 2006
This post was written by Melanie Matthews

Health savings accounts received a boost during President George Bush’s State of the Union address last night.

Bush proposed giving individuals who purchase HSAs on their own to receive the same tax advantage as those with employer-sponsored insurance; and eliminating all taxes on out-of-pocket spending through the HSAs, not just their deductible as provided under current law.

Health savings accounts have really begun to emerge as one way to control healthcare spending by putting more onus on the consumer to be sensitive to healthcare costs. A Fidelity Investments
study found that almost half (45 percent) of large employers surveyed plan to offer a consumer-driven health plan (CDHP) this year.

This focus on HSAs and consumer-driven healthcare as a mechanism to control healthcare costs will truly only succeed if consumers are given the information they need to make informed healthcare decisions, including quality data and cost data; and we’re just not there yet.

This week, I conducted an unscientific research project on the reporting of quality information by hospitals and health systems. While I didn’t come close to visiting all 5,700 hospital web sites in the United States, I did visit a select few that are historically early adopters and are leading quality-based initiatives. Very few are actually reporting on their performance.

This month, HIN is conducting an online survey on hospital/health system performance report cards. There are challenges to reporting this type of information, ranging from data collection to knowing what kind of impact it can have on an organization. You can post your views on report cards at:

Another challenge to address is educating consumers on using this data. Presbyterian Healthcare Services provides a description next to its quality indicators of the desired performance, comparing Presbyterian’s performance with the National Top 10 percent and the National Average. Other hospitals compare only their previous year’s performance.

The different reporting schemes make it difficult for a consumer to truly evaluate hospitals based on quality measures.

PricewaterhouseCoopers, in its Top 10 Issues for Healthcare 2006 predicted that health organizations will need to focus on developing proactive, coordinated reporting of their prices, error rates and safety standards this year. I think a coordinated approach is key to achieving the cost reductions that we’re seeking HSAs to achieve.

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