Health savings accounts and health reimbursement arrangements appear to lead to sustainable reductions in medical cost trends.

Researchers at CIGNA Healthcare, Bloomfield Conn., a unit of CIGNA Corp., Philadelphia, have published that finding in an analysis of claims from 30,800 first-year health account plan members and 121,700 members who had been in health account plans for 2 or more years.

The researchers compared health account plan members with 286,600 members of traditional health maintenance organization and preferred provider organization plans.

Cost trends were down 20% for health account plan members with diabetes, 18% for health account plan members with high blood pressure, and 13% for all health account plan members, the researchers report.

Health account plan members received care that was similar to the care that members of traditional health plans received, suggesting that the cost trend reduction had more to do with better chronic disease management than with individuals doing without needed care, the researchers contend.

The researchers note that they excluded catastrophic claims in excess of $50,000 from the study, to reduce the effects of random variations within smaller sets of data on the study results.