Holders of personal health accounts may be more likely than members of other health plans to miss work because of decisions to go without medical care.
Researchers at the Henry J. Kaiser Family Foundation, Menlo Park, Calif., have published figures supporting that idea in a summary of results from a recent survey of 22,560 U.S. residents ages 18 to 64.
The researchers found that 272 of the participants, or 1.2% of all participants, had individual or group high-deductible health coverage combined with a health savings account or a health reimbursement arrangement.
The researchers also interviewed a control group of 715 U.S. adults enrolled in conventional employer-sponsored group heath plans.
The researchers found that health account holders had higher incomes and more education than members of the control group.
About 57% of the health account holders had college degrees, and 45% had annual household incomes over $75,000.
In the control group, only 35% of the participants had college degrees and only 30% had incomes over $75,000.
U.S. Government Accountability Office researchers have pointed out that comparing performance health account plans with conventional group plans is difficult, because most health account plans are new, and new health plans of all kinds tend to have lower satisfaction rates than well-established plans.
Some of the health account holders in the Kaiser survey have individual health coverage, and researchers at the Commonwealth Fund, New York, recently noted that holders of individual coverage tend to have lower satisfaction rates than members of group health plans.
The Kaiser researchers found that 57% of the health account holders in their sample gave their plans an overall grade of A or B, compared with 69% of the members of conventional health plans.
Although members of the health account plans were more likely to fear exposure to large medical bills, only 11% of the health account holders said they currently had medical bills that were overdue, compared with 17% of the members of conventional plans.
But about 23% of the health account holders said they had gone without medical care they needed in the past year because of concerns about cost, compared with 11% of the members of conventional plans.
Going without care had caused 9% of the health account holders to suffer from a “temporary disability” in the past year and 2% to suffer from a “long-term disability” in the past year, according to the Kaiser researchers.
In the control group, only 5% of the participants said going without care had led to a temporary disability, and only 1% said going without care had led to a long-term disability.
The Kaiser survey team did not define the terms “temporary disability” and “long-term disability” when asking participants about experiences with disability.
Another limitation of the results is that the number of health account holders who reported suffering any disability was small and could have been affected by random fluctuations as well as by differences between the demographics of the health account group sample and the control group.
The researchers also report that only 7% of health account holders said they have used their plans’ Web sites to compare physicians or hospitals based on quality, and only 5% have used plan Web sites to compare providers based on cost.