Lively HSA spending and national health trends
How HSA spending has changed year-over-year.
HSA spending overview by year
HSAs can be split into three categories of account capabilities: savings, investments, and spending. How Lively account holders use their HSAs tends to reflect the overall state of healthcare spending. Understanding this spending can help brokers and employers see how these accounts are actually being used and see major trends in HSA spending.
Spending on hospital visits and services rose nearly 14% in 2022, surpassing pre-pandemic levels.
Spending on vision and eyewear increased by over 150% in 2022.
Spending on mental health, already the smallest percentage of HSA spending, declined by 19% in 2022.
HSA consumer spending habits
Understanding spending habits and trends
Spending on prescription drugs fell 25% in 2022, back to pre-pandemic levels.
The majority of HSA spending is on routine doctor visits and preventative care, similar to the past several years. There are several important fluctuations and trends to note:
Hospital visits rose by 13.7%, surpassing pre-pandemic levels, perhaps due to increased access to hospitals for voluntary and non-urgent surgical procedures as the pandemic eased.
Vision and eyewear spending also increased by over 150%, perhaps as people became more comfortable with in-person visits they may have put off during 2020 and 2021. In addition, perhaps due to high inflation, they turned to their HSA to help cover regular expenses, such as classes, that could be a large purchase from a monthly budget.
Dental spending has remained higher than pre-pandemic levels for the second year in a row, growing 15 percent since 2020, perhaps reflecting that consumers have gotten back to a regular dental care routine.
Prescription drug spending fell 25% since 2021, and 31% since 2020, back to pre-pandemic levels. This could be because consumers are able to visit the doctor more easily and can seek holistic care or because drug prices surged during the pandemic, causing consumers to turn to their HSAs to cover them.
Mental health spending continues to decline, despite an increased focus on its importance by employers and many HR professionals. Mental health spending already accounts for a very small percentage of HSA spending and declined by 19% in 2022. This may be due to continued stigma around seeking mental healthcare or long wait lists for providers. Employers may consider increasing HSA education around qualified expenses or offering a benefit specifically to support mental health and wellness, such as access to wellness apps through a Lifestyle Spending Account in order to encourage employees to focus on their mental, as well as physical, wellness.
Dental care spending grew for the second year in a row and 15% since 2020.
Debit card transactions
Lively account holders spend $17 above the industry average per transaction.
Lively account holders are active debit card users, spending an average of $129 per debit transaction in 2022, $17 above the industry average per transaction of $112 as reported by Devenir in their 2022 year-end report.
Lively’s average debit card transaction was $131 in 2021, compared to an industry average of $118. The slight drop in spending may be due to less need for over-the-counter products as the pandemic eased. Easy access to a debit card, which can be used to purchase HSA eligible items both in-person and online is an essential component of an HSA account.
Average spend amount per Lively debit card transaction.
Despite continued economic volatility, Lively HSA account holders continue to use their HSAs for regular and expected medical services.
Despite continued economic volatility, Lively HSA account holders continue to use their HSAs for regular and expected medical services. The slight rise in hospital visits shows account holders are also using their HSAs to cover the unexpected medical emergencies or voluntary surgeries. By doing so, they access an important tool in combating financial stress and reduce their overall out-of-pocket healthcare spending, compared to Americans who don’t have access to an HSA and the triple-tax savings that comes with it.