Individuals who enrolled in high-deductible health care plans linked to health reimbursement arrangements spent less on medical services than those who remained in preferred provider organization plans, suggesting the HRA enrollees were healthier, according to a government study.

The Government Accountability Office study released Monday compared medical service usage and spending of enrollees at two large employers—one public and one private—that were not named.

On average, HRA enrollees of both employers spent less on medical care before they switched to the HRA in 2003 than those who remained in the PPO, “suggesting that they were healthier,” the GAO said in the report.

For example, average medical spending for the public employer's HRA group averaged $823 per enrollee in 2001 and 2002 compared with $2,328 for the PPO group. Such spending at the private employer averaged $623 per enrollee in 2001 and 2002 for the HRA group compared with $1,188 for those remaining in the PPO, the GAO found.

The difference isn't surprising, benefit experts say. HRA-based plans expose enrollees to higher cost-sharing requirements than more traditional plans. As a result, healthier employees would be more likely to gravitate to HRAs than those who use more medical services and would be more exposed to big medical bills if they switched to an HRA.

Medical spending differences between the two groups continued after the introduction of the HRA. Between 2003 through 2007, medical care spending averaged $1,301 per enrollee for those enrolled in the public employer's HRA vs. $3,206 for those in the PPO.

At the private employer, annual medical spending between 2003 through 2005 averaged $775 for those enrolled in the HRA and $1,395 for those enrolled in the PPO.

The GAO report, “Consumer-Directed Health Plans,” which was requested by Rep. Henry Waxman, D-Calif., and chairman of the House Energy and Commerce Committee, and Rep. Pete Stark, D-Calif., the chairman of the House Ways and Means Health subcommittee, is available at http://www.gao.gov/new.items/d10616.pdf.