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Despite a rebound in out-of-pocket health care spending in 2021, health savings account balances grew on average over the course of the year, according to a report by the Employee Benefits Research Institute, reports 401K Specialist. Patients pursued health care services at a higher rate in 2021 compared to 2020, given the stay-at-home orders at the onset of the COVID-19 pandemic. As a result, the average end-of-year balance was higher than the average beginning-of-year balance in 2021, rising to $3,902 from $2,645, the report says.