Cooperative marketplace reform is making health care more affordable and accessible.

I’ve been talking a lot recently about how marketplace reform can and is already improving the health care system, as insurers, employers, physicians and health care facilities work together to implement new programs and initiatives. One last example involves the cooperation of employers and insurers to actively engage employees in making health care decisions: the high deductible-health savings account (HSA) combination that is catching on like wildfire across the country.


A high deductible plan is typically the least expensive healthcare insurance option for a business, while the HSA enables employees to pay for their share of health care with pretax dollars. The HSA empowers people to become better health care consumers by gaining a greater understanding of the actual cost of their health care.

The HSA concept is great, but to make it work as well as it can requires both insurers and employers to step forward. Insurers have helped make HSAs more affordable and beneficial to employees by offering plans that do not make people pay for preventive care such as annual physicals and pap smears as part of the deductible, thus encouraging people to get the tests needed to identify health problems in their earliest stages. And many employers are contributing funds to the HSA accounts their employees open to encourage the employees to get started.

The result has been rapid acceptance of the HAS concept. Recent America’s Health Insurance Plans (AHIP) studies report that in the past two years, the number of people enrolled in HSA plans has grown by 90% and now stands at 6.1 million nationally. AHIP reports that 27% of people with HSAs in employer-based plans were previously uninsured.

HSAs, closed networks, crunching clinical data—some may find the improvements I’ve been talking about to be piecemeal, but they represent just the tip of an enormous iceberg of marketplace innovation that is reshaping health care.