Few members of employer-sponsored health savings account programs seem to have much luck negotiating, or even determining, prices before receiving medical care.

Researchers at the U.S. Government Accountability Office have published that conclusion in a review of early HSA plan members’ experience.

Many HSA plan members who participated in a GAO focus group said they are reluctant to ask doctors about the cost of care, but members also noted that physicians do not always know the cost of the services provided, and that the information generally was handled through a billing office, John Dicken, a GAO director, writes in a report summarizing the research.

“Participants reported that only limited information was available regarding key quality measures for hospitals and physicians, such as the volume of procedures performed and the outcomes of those procedures,” Dicken writes.

Other GAO findings:

- HSA plans once offered to free consumers from provider networks, but the HSA plans included in the study now seem to use provider networks that are similar to the provider networks used by traditional plans.

- Premiums for HSA-compatible individual coverage tend to be about 30% lower than the premiums for comparable traditional coverage.

- The average adjusted gross income of the 108,000 tax filers who reported HSA contributions for 2004 was about $133,000, compared with $51,000 for all tax filers under age 65, according to IRSA data.

- In 2004, about 55% of HSA-eligible plan employees contributed to HSAs.

- When GAO researchers compared 3 employer-sponsored HSA plans, they found that only 38% of the employees who were in a plan with no employer HSA contributions put money in their HSAs. The percentage of eligible employees who contributed to their HSAs was 64% and 90% at the 2 employers that contributed to employees’ HSAs.

A copy of the GAO report is on the Web at Document Link