Long-term effects of Indiana state government’s switch to a consumer-directed health plan are unknown, but early results are demonstrating money-saving changes in behavior. As more employees switch to health savings accounts, it’s worth watching how both the bottom line and workers’ health are affected.

Niki Kelly reported Sunday that 85 percent of state employees now participate in a health savings account plan, as opposed to the traditional health insurance plan. Under the new option, employees pick up a larger share of health care costs in exchange for lower insurance premiums. Out-of-pocket costs are paid with pretax dollars.

Some health economists are wary of health savings accounts. They warn that the savings simply are the result of patients putting off doctor visits.

“Don’t assume that consumers having more financial skin in the health care game will make them smarter health consumers,” writes Jane Sarashon-Kahn, who blogs at HealthPopuli.com. “Many healthy citizens make what seem to be smart fiscal decisions for health care consumption in the short run – like postponing visits to doctors when they feel ill, or skipping doses of medication. These often lead to longer-term dismal physical outcomes.”

A survey by the Employee Benefit Research Institute also found no evidence to suggest health-savings account owners are better consumers – checking prices, examining hospital quality ratings or talking with doctors about the cost of treatments or prescriptions.

But there’s no mistaking the differences in how Indiana state workers with a health savings account and employees with the traditional plan accessed health care. The average prescription cost was $15 higher on the traditional plan, and physician office visits per 1,000 members were as many as 2,311 visits more. Emergency room visits per 1,000 were almost double for employees with a traditional plan.

As participation in health savings accounts grows, there also is the likelihood that more information will be available to make for better health consumers. Health savings accounts have been around only since 2004, growing to about 5.7 million accounts last year, or about 12 percent of the population covered by private insurance. With so few consumer-directed plans, the availability of price information has been limited and – in turn – the comparison shopping that could drive down costs.

Fort Wayne Community Schools is offering a health savings account to its employees for the first time, effective in 2012. While a low-deductible plan – at a higher cost – is available to current employees, the district expects $4 million in savings with its new high-deductible health savings account.

It’s still too early to determine whether health savings accounts deliver both savings and better health outcomes for employees, but the encouraging results from Indiana’s experience suggest it’s worth studying.