Cut costs by adding benefits? Why an HPA may be your secret weapon.

Rising healthcare costs are always a challenge for benefits teams, but 2025 has many really feeling the pinch.

Commercial healthcare spending is projected to grow 8% from 2024 to 2025, fueled by ongoing inflationary pressure and the growing demand for glucagon-like peptide-1 (GLP-1) drugs.¹ And it comes on the heels of a 7% increase in average family premiums in 2024, when Kaiser Family Foundation reported a record high of $25,572 for employer sponsored coverage.²

In these headwinds, it’s easy to understand why many organizations might consider cuts to their benefits packages. But one of the best ways to tackle healthcare costs and reduce your overall spend is by actually adding a benefit—the Health Payment Account (HPA).

An HPA is a low-cost, flexible payment tool that gives employees immediate access to an employer-defined revolving line of credit—up to $2,000 through HealthEquity partner Paytient—to cover out-of-pocket healthcare expenses, interest free.^3,4

With an HPA, your people have access to another payment option—one that provides peace of mind and potentially enough comfort to select a lower premium health plan, seek preventive care, and use funds on expensive but niche healthcare needs.

All of that can save your organization significant amounts of money. In this article, we’ll explore how.

HPAs can boost adoption of lower-cost health plans.

One of the simplest ways to reduce your overall healthcare spend is to encourage employees to choose lower-premium plans. After all, Health Savings Account (HSA) plan premiums for families were a full 9% lower than the family premiums of traditional PPO options in 2024.² But there’s a catch: HSA plans are also high-deductible health plans (HDHPs), which may come with higher out-of-pocket costs. Many employees aren’t comfortable with that tradeoff.

That’s where HPAs help. A recent study from Paytient found that 34% of employees with access to an HPA would consider switching to a plan with lower premiums.⁵ And in practice, employers have seen even greater success: in one case study from a Paytient client, 40% of employees opted into an HSA-qualified health plan when an HPA was offered alongside it.

When employees have flexible, interest-free ways to pay for care, they’re more likely to consider cost-effective plan options. That saves money for both your people and your organization.

HPAs also maximize the value of HSAs themselves. HPAs provide employees with another way to pay for care, giving them increased flexibility. This can allow employees to keep their HSA funds intact, growing with interest or investment for the long haul. Alternately, employees can pay back their HPA with pre-tax funds.⁶

All of that means employer contributions stretch further, and employees start to think more intentionally about how they engage with their benefits, planning ahead, asking questions, and generally taking a more active role in managing their care.

With HPAs, fewer employees incur the costs of deferred care.

Cost is one of the top reasons people avoid getting care, even when they need it. According to a 2024 Kaiser Family Foundation study, one in four Americans said they put off getting healthcare because of the cost.⁷ And when employees skip preventive care or delay needed treatments, those costs can snowball and end up leaving them—and your organization—with an even higher bill.

A study from the Commonwealth Fund found that over half of people with employer coverage who deferred care due to cost felt their health problem got worse because of the wait. That can lead to more ER visits, avoidable hospital admissions, or simply higher costs because of worsened health.⁸

HPAs can help prevent that. Paytient found that 80% of employees with access to an HPA card said they would have postponed or skipped care without the HPA, and 78% felt they were healthier because of their HPA.⁹

With lower bills and healthier employees, your organization’s total healthcare spend is likely to be much less.

Christy Goldberg-Hirsch, Vice President of Benefits, HRIS, and Payroll at RR Donnelley—a HealthEquity client—also spoke of the “dignity” HPAs gave employees.

“Our people don’t have to face the embarrassment of saying, ‘I can’t afford that,’ because they know they can use their Health Payment Account,” said Goldberg-Hirsch.

HPAs can meet employee demand for expensive treatments.

From GLP-1 medications to fertility treatments, employees today are seeking more from their benefits. But expanding your organization’s health plan to include every trending treatment isn’t always feasible or affordable.

HPAs offer a middle ground. Because they can be used on a wide range of healthcare expenses (including niche or high-cost care), they allow you to support your people without overhauling your entire plan or absorbing even higher premiums. It’s a flexible way to meet evolving expectations while protecting your bottom line.

HPAs offer big savings for a small cost.

When it comes to cutting costs, most teams think about taking benefits away. But adding the right benefit—like an HPA—can reduce plan costs, improve outcomes, and drive smarter healthcare decisions across your workforce.

Want more ways to stretch your benefits budget? Check out the benefits cost savings playbook and explore how HealthEquity tools can help you save more without sacrificing value.