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Study: Raising Co-Pays Raises Hospital Costs
A new study in the latest New England Journal of Medicine shows that raising co-pays in Medicare led to higher hospitalization rates and higher health care costs. The 866,000-person study compared Medicare beneficiaries in plans who had their co-pays raised to people who did not. For every 100 enrollees, the first group experienced 19.8 fewer physician visits, but 13.4 more days in the hospital. "The effects of increases in copayments for ambulatory care were magnified among enrollees living in areas of lower income and education and among enrollees who had hypertension, diabetes, or a history of myocardial infarction," the authors noted.
This is one more piece of evidence showing that forcing medical consumers to have "more skin in the game" -- like taxing high-cost insurance plans -- will backfire when it comes to reducing long-term health care costs.
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Comments
Merrill, Good post, but
Merrill,
Good post, but your conclusion in a little too oversimplified. The study shows that indiscriminate "skin in the game" leads to pennywise-pound foolish results. However, plans that would put higher co-pays on ineffective or low cost-effective treatments-- say, arthroscopic knee surgery, cardiac stent placements, branded drug coverage when adequate generic is available, CT colonoscopy-- the list is long-- those SHOULD have high co-pays.
Your rightful concerns about "low cost" plans staying under the excise tax levels is fair-- dropping actuarial value is a cruder and easier way than driving utilization and benefits to high-value medicine. But the "skin in the game" approach applied to value-based medicine will be more effective than indiscriminate co-pays AND shielding consumers for any direct expenses for the health care consumption. It just requires some heavy lifting on classifying low-value care, which is precisely the government intervention that we should be pushing for in reform.