While health savings accounts (HSA) are best utilized as a retirement vehicle for employees in a high-deductible health plan (HDHP), the COVID-19 pandemic caused many to dip into those accounts for health expenditures last year.
This was a main finding by Lively, Inc. in its “HSA Spend Report,” which revealed spending increases for prescription drugs (+32%) and chiropractic care (+20%). The survey also found that average account holder's routine visits saw a sharp decline when compared to 2019: doctors visit and services (-3%), hospital (-9%), lab work (-15%), and dental spending (-9%).
COVID-19 restrictions and the postponing of non-essential procedures led to decreased doctor visits, hospital spending and lab work. An increase in prescription spending resulted from reactive stockpiling at the start of the pandemic. In March, speculative treatments for COVID-19, such as chloroquine and hydroxychloroquine, caused a surge (+125%) in prescription spending across the country, Lively noted. Anti-anxiety, anti-depression, and sleep medication orders increased as the length of stay-at-home orders were extended. The spike seen in chiropractic care was likely the result of improper ergonomic set-ups as people worked from home.
“COVID-19 has left millions of Americans feeling uncertain about their financial futures. Many have had to dip into their long-term savings to stay afloat,” said Shobin Uralil, COO and Co-Founder of Lively. “While HSA account holders may have spent their money differently to adapt to the pandemic this year, rising health care costs are still making it tough to save for things like retirement. It's never been more important to ensure that people with HDHPs know about their potential savings opportunities to get back on track for future health events.”
Other key findings and trends to note:
- HSA account holders are spending, not saving: Expected costs, routine visits, and prescription drugs account for 86% of annual HSA spending.
- The cost (and share) of hospital care is on the rise: Although national and HSA spending were down for hospital care due to the cancelation or postponement of elective procedures in response to COVID-19, the decrease was proportional.
- National pharmacies dominate prescription spending, but 'superstores' gained market share: In-store purchases, led by the larger national pharmacies (Walgreens, CVS, and RiteAid), still dominate the pharmaceutical market. Between 2019 and 2020, 63% more HSA account holders chose to fill prescriptions in 'superstores' (Walmart, Target, Costco, and Sam's Club), likely spurring from the convenience and decreased exposure to COVID-19.
- Mental health spending remained steady: While the amount of mental health spend did not increase, how consumers accessed help did see an increase in virtual mental health experiences from 15% in 2019 to 16.3% in 2020.
- Contactless payments are accelerated in the health industry: When health payment decisions were made, more individuals chose the most physically safe opportunity at the point of sale than in the past. This includes choosing online versus in-store purchases and completing doctor service visit transactions with a contactless card or mobile wallet.
“It remains unknown whether new trends or changes in health spending due to COVID-19 will be permanent,” Uralil said. “But no matter what, HSAs will continue to be vital for American families to shelter themselves from rising out-of-pocket health care costs. Raising HSA contribution limits, expanding HSA eligible expenses, and letting more Americans take advantage of HSAs would help put more savings into the pockets of people across the country.”