How to drive HSA adoption and engagement

As healthcare costs continue to climb and employees grow increasingly uncertain about their financial futures, employers are feeling the pressure to offer benefits that do more than check the box—they need to provide real value. Health savings accounts (HSAs) have become a powerful tool for doing just that, but it’s important for employers to understand how their employees think and feel about HSAs.

Recently, we sat down with Jason Cook, vice president and HSA practice lead at WEX to explore new research conducted in partnership with Visa. Their goal? To deeply understand what motivates consumers to adopt and engage with HSAs—and what holds others back.

Here’s what we learned.

Why WEX and Visa studied HSA adoption

The research set out to answer five key questions:

• What motivates people to use their HSAs?
  
• What keeps non-adopters from converting?
  
• Who do consumers turn to for advice about HSAs?
  
• What tools do they find most useful?
  
• What messaging resonates most?
  

By looking at behaviors, perceptions, and emotional drivers, the WEX and Visa teams uncovered a clearer picture of how to help employees better understand—and benefit from their HSAs.

The emotional needs behind HSA engagement

One of the most eye-opening findings was just how emotionally charged healthcare and financial decisions can be. Across all participants, several emotional themes surfaced consistently:

• Peace of mind
  
• Less anxiety and stress
  
• Confidence
  
• Security
  
• Control
  
• Feeling empowered
  

These emotional needs play a major role in how consumers evaluate healthcare decisions. While themes like security and control have always been prominent, the latest research revealed a new and meaningful shift: consumers increasingly want to feel empowered.

This shift indicates that consumers don’t just want protection—they want to feel capable, informed, and in charge of their choices.

What motivates people to use an HSA?

The research revealed two categories of motivators: functional and emotional.

Functional benefits

These are the tangible advantages that make HSAs financially smart:

• Significant tax advantages
  
• Valuable employer contributions
  
• The ability to plan for future expenses
  
• Opportunities to invest and grow funds
  

Emotional benefits

These benefits align directly with those core emotional needs:

• A sense of peace of mind
  
• A way to hedge against future health expenses
  

Together, these motivators make HSAs uniquely powerful—combining financial strategy with emotional reassurance.

The barriers holding back non-adopters

Despite their value, HSAs still have adoption hurdles. According to Cook, the biggest barriers include:

• High-deductible health plans (HDHPs) not being the right fit for everyone
  
• Low awareness of HDHPs—many employees default to PPO/HMO options
  
• Confusion about contribution and spending rules
  
• Uncertainty around how much to set aside
  

In short: employees often don’t adopt because they don’t fully understand the product or don’t feel confident navigating it.

How employers can improve HSA education and engagement

So how do you bridge the gap between potential and adoption? The research highlighted four key communication strategies employers should prioritize:

1. Simplify the message

Cut the jargon. Use plain, relatable language to explain what an HSA is, how it works, and why it matters.

2. Highlight employer contributions

Employees who know they’re receiving free money are much more likely to participate.

3. Educate non-adopters

Don’t assume everyone is already familiar with HDHPs or HSAs. Create clear, beginner-friendly content to help hesitant employees feel confident.

4. Use multiple channels

People learn in different ways. Pair emails with videos, benefits portals, one-pagers, webinars, and in-person sessions to meet employees where they are.

As open enrollment approaches, employers have a unique opportunity to empower their workforces. By understanding the functional and emotional drivers uncovered in WEX and Visa’s research, benefits leaders can craft more effective messaging—and ultimately, build a benefits experience that inspires confidence, reduces stress, and supports long-term financial wellness.

Don’t forget to check out our interview with Jason Cook to learn even more about HSA adoption and engagement!

The information in this blog post is for educational purposes only. It is not legal or tax advice. For legal or tax advice, you should consult your own legal counsel, tax and investment advisers. 

WEX receives compensation from some of the merchants identified in its blog posts. By linking to these products, WEX is not endorsing these products.