How do HDHPs impact employee wellness and productivity?

When HDHPs first emerged, they were very promising, but the data now clearly shows that the only real benefit is a short-term reduction in plan costs due to cost shifting and delayed care. The industry hoped cost/quality tools would be developed for those on HDHPs to "shop" for the best value, but unfortunately, they never materialized as everyone hoped. Ultimately, people avoid necessary care, they get sicker and more expensive to manage at the end of the day. Sure, "preventive" is 100% covered but that's more marketing than anything. For instance, someone getting a 100% covered preventive colonoscopy could face a $1,500 bill if a polyp is found which flips the claim to a non-preventive procedure. People avoid care as a result.

HDHP’s encourage (rather force) an employee to look out for their own wellness. If they don’t - they’ll wind up spending out of pocket on medical bills.

Stop calling it a "High Deductible Health Plan". Talk about marketing failures. Reminds me of the early 1980's when 401k features were once called "salary reduction savings plans." Try HSA-capable. "High" is a misnomer as the minimum will be $1,600 in 2024. Keep in mind that a $100 deductible in 1970, indexed for increases in national health spending since then (7.4% per year, CMS/HHS data), would be in excess of $4,300 today. In the 1970's, Americans paid 30+% of all health expenses out of pocket, and today, less than 10%.

To appreciate the benefit of the HDHP & HSA employees need to see the cost comparison to the traditional plan- they need to see the savings they incurred in giving up their traditional plan. They immediately dislike the plan when a claim comes up that they have to pay for, but if they re-see the cost savings, where in many cases they are better off despite paying more in claim cost than the traditional plan - they'll take a sigh of relief in knowing (again) that they're in the right plan.

Preventative care is covered 100% - I disagree with the cons. HDHP’s are a win-win for employer and employee, worth investigating.

HSA-capable coverage only works if priced right, well-presented, where workers enroll and contribute to the HSA. Any/every deductible is an impediment unless the worker is prepared to pay. They don't call it a Health SAVINGS Account for nothing. How to prompt saving? What did you do in your 401k plan?

This statement incomplete. Preventive care is covered at 100% on all plans including HDHP's since the ACA became law. Employees who now pay less for the HDHP, are encouraged to put those saved dollars away today on a tax favored basis to use at a later time. The money is the asset of the employee forever! Furthermore, employers can also reallocate dollars they were spending on their old health plan and often offer incentive or matching contributions into the employee's HSA which is also theirs to keep for use at a later time. If communicated correctly, HSA's are a true win for all! In my experience, poor outcomes result from poor planning. An HSA is not a once size fits all solution, but certainly can fit most if executed correctly.

Originally, HDHP's were positioned as a way to "get employee's skin in the game." At that time, 20 years ago, there was a burden (expense) but no ability for patients to manage costs. Since the CAA, that's changed a lot and price transparency means that savvy shoppers can look for better value - but they have to be very savvy. Look to things like FairHealth.org and TryBilly.app for consumer-ready solutions to shop price and quality metrics. Consumers can now be at least partially informed as to the deal they're getting, which is a lot better than it was in the past.

Employers can also assist by offering a robust wellness plan that can keep their employees healthy via prevention. It’s worth investigating.

Nope. Few read. Again, how did you prompt participation, contributions, preparation via your 401k plan? Might work here as well. See: https://401kspecialistmag.com/hsas-and-401ks-better-together-part-one/

Try having a HSA expert who is a HSA owner write the next article on HSAs The title is misleading. "How do HDHPs impact employee wellness and productivity?" The author fails to adjust for the impact of actually saving in a HSA. That is, it isn't the "Employee Benefits Design" which triggers potential negative impacts - all deleterious impacts on employee wellness and producitivy are more likely the result of poor execution, substandard communications and marketing, etc. "Done Right", HSA-capable coverage has all the same value as a traditional PPO or HMO with a smaller deductible amount - and potentially more value - in terms of reinforcing and enhancing an organization's wellness and productivity initiatives.