Thanks largely to expanded marketing and increased distribution, OptumHealth Financial Services has boosted its health savings accounts 35% over the past two years, but health-care reform could hamper future gains.

The company's banking arm, OptumHealth Bank, has 478,000 health savings accounts with $830.5 million in deposits and investment assets, up 80%, from two years earlier. It is one of the largest players in the HSA market, along with HSA Bank, UMB Financial Corp., Wells Fargo & Co., JPMorgan Chase & Co. and U.S. Bancorp.

Until the fall of 2007, OptumHealth Financial had focused on supporting the health plans within its parent company, UnitedHealth Group Inc. in Minneapolis, said Chad Wilkins, the chief executive of OptumHealth Financial, in an interview last week.

"We weren't selling very aggressively in the direct marketplace," said Wilkins, whose business changed its name from Exante Financial Services in March 2008.

(OptumHealth Financial is a unit of OptumHealth Inc., which is part of UnitedHealth Group.)

Wilkins joined Exante in 2007 from U.S. Bank Corporate Payment Systems, a unit of U.S. Bancorp.

At OptumHealth Financial, he has led an effort to build external, broker-driven distribution of products like health savings accounts, flexible spending accounts and health reimbursement accounts to employers and health-care providers. OptumHealth Financial is now working with nearly 5,500 active brokers, and is recruiting new ones on a continuing basis. "We've gone from an immaterial percentage of new sales through external sources to 30% based on what we're seeing come in from our direct sales efforts," he said.

It remains to be seen whether health savings and other forms of consumer-directed health care will be judged to meet the minimum standards for the White House's health-care initiative. Deposits in health savings accounts nationally stood at $6.1 billion in January, according to Boston financial research and consulting firm Celent, which is part of Oliver Wyman Group, a New York consulting unit of Marsh & McLennan Cos.

Vik Kayshap, the CEO of Canopy Financial in San Francisco, said his company, which provides processing and technology solutions for HSA custodians, continues to view a "massive migration" to health savings accounts, which must be used with high-deductible health insurance plans. "We do not see employers moving to the sidelines at all," he said.

In the most recent enrollment season, HSA-compatible insurance plans increased by 35%, Kayshap said.

Meanwhile, deposits continued to flow into health savings accounts, according to data from Canopy's clients, which have over 1 million health savings accounts under custody. Individual balances rose 6% and family HSA balances climbed 8% in the second quarter of 2009, from the previous quarter, extending an upward trend that started in the first quarter. In the third and fourth quarters of 2008, average balances in those categories either stagnated or fell, according to Canopy's data.

Assets in the brokerage accounts that are commonly linked to health savings have continued to rebound as the stock market has rallied. Average individual health investment account balances rose 28% in the second quarter of 2009, from a year earlier, while average family accounts' balances increased 21% from the first quarter.

OptumHealth Financial's health savings accounts should increase about 30% a year, in line with industry projections — assuming health-care reform does not throw a wrench into growth, Wilkins said. So far, employers have not shied away from adopting health savings accounts because of the possible impact of health-care reform, he said. "It definitely is a topic," he said. "But we haven't seen a real reduction in the number of employers going to consumer-directed health plans or HSAs."

Employers, facing cost pressures and decisions about the insurance options to offer, cannot wait for the debate to play out, Wilkins said. And in any case, employers in general understand "that the changes [brought by reform] would not take place until 2013," he said.

OptumHealth Financial is not passively watching the debate. It is "educating everyone who will listen" to the case for health savings accounts, Wilkins said. "We believe HSAs are a good thing for health care," he said, "and they serve a lot of, if not all of, the tenets promoted by the administration, like helping individuals and employees drive down costs."

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