Key findings
Critical insights, metrics, and indicators from HSA saving, spending, and investing in 2023.
HSAs function as intended
Account holders are using their HSA for both routine spending on ongoing and preventative care, as well as emergency healthcare coverage, with 50% of transactions at pharmacies, including big box stores, for over-the-counter items.
Rising prescription drug spending
Spending on prescription drugs rose 17%, reflecting higher prescription drug prices overall.
Declining spending on mental health
Spending on mental health continues to fall year over year. Only 0.15% of HSA account holder spending was on mental health, down 20% from 2022.
Investments drive HSA balance growth
15% of Lively account holders invest their HSA balance, nearly twice the industry average of 8%. Investment growth drove HSA balance growth both at Lively and industry wide.
Both account balances and withdrawals increased
Account holders are using their HSAs both for tax-savings and to save on everyday health-related expenses and to counteract higher prices for prescription drugs, healthcare, and over-the-counter items.
HSAs are a critical part of a holistic benefits package
Creating a cost-effective, competitive, and flexible financial benefits package is just as, or more, important than last year according to 80% of benefits leaders.