What’s the impact of offering HSA-compatible HDHPs versus lower-deductible plans on total employer spend?

HDHPs with HSAs can reduce premiums and offer short-term savings, but they often lead to delayed care and unpredictable long-term costs. Lower-deductible plans cost more up front but encourage early engagement and better long-term outcomes. The best approach combines affordability with built-in, $0 primary care access.

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HDHP + HSA: Lower premiums, higher risk of underuse

• Premium impact: Typically 10–20% lower than PPO or low-deductible plans.
• Employer contribution: Many employers offset higher deductibles with HSA contributions while maintaining lower total spend.
• Risk: Employees with limited savings may delay care, leading to unmanaged conditions and higher long-term claims.
  
  • Short-term: Lower premiums.
  • Long-term: Potentially higher claims due to deferred care.

Lower-Deductible Plans: Higher premiums, stronger engagement

• Premium impact: Usually 10–20% higher than HDHPs.
• Employee experience: Predictable, lower out-of-pocket costs make care more accessible.
• Employer benefit: Better engagement with preventive care, fewer avoidable hospitalizations, and higher retention due to improved benefit perception.
  
  • Short-term: Higher premiums.
  • Long-term: Greater cost predictability and fewer major claims.

Balancing both: Tiered or hybrid approach

• An HDHP + HSA for employees prioritizing lower premiums.
• A buy-up, lower-deductible plan for those wanting predictable costs and fuller coverage. Best practice: Pair HDHPs with $0 primary care access through solutions like Vitable. This preserves cost savings while preventing care avoidance.

The real cost driver: utilization 

• Regardless of plan type, how employees use care determines your total spend. Plans that include $0 primary care, mental health, and telehealth help stabilize costs by catching issues early and avoiding expensive claims.

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Vitable complements both HDHP and lower-deductible structures by giving employees $0 access to primary, preventive, and mental health care (virtually or in-home). This reduces the downside of HDHPs while helping employers control long-term spending and improve health outcomes.

• HDHP + HSA: Lower premiums, higher risk of deferred care.
• Lower-deductible plan: Higher premiums, stronger engagement and stability.
• Best approach: Combine HDHP savings with Vitable’s $0 primary care access to keep costs low and care accessible.

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