Posted on May 7, 2010 10:46
Categories: Employer and Individual Insurance
Topics: Cost-effectiveness | Employer-Sponsored Coverage | Individual Coverage | Out-of-Pocket | Providers | Spending
A recent study conducted by researchers from Tufts University’s School of Medicine and Boston University’s School of Public Health published in the American Journal of Managed Care found that employees who were aware of their copayment or premium costs were more likely to opt for cost-efficient medical treatment. The researchers surveyed government workers in Massachusetts, finding that workers who knew their premiums or their copayments were more likely to seek care in doctors’ offices rather than emergency rooms.
From the report:
Persistent rising healthcare premiums have induced employers to consider cost sharing as a tool for controlling unnecessary, costly utilization of healthcare services. Paying for some of the costs of their care may make consumers more aware of the high cost of healthcare services, thus encouraging more efficient and appropriate use of services. For example, establishing a higher level of cost sharing for emergency department (ED) visits and a lower level of cost sharing for office visits may motivate patients with minor healthcare needs to seek care in a doctor’s office instead of the more costly ED. However, this tool assumes people have accurate knowledge and understand their cost-sharing responsibilities. Misunderstanding about the amount of cost sharing could modify the actual effect of this incentive. It is important to learn more about employee understanding of cost-sharing responsibilities and how this influences behavior in a healthcare environment where changes to cost-sharing features are routinely used.
Full report: Knowledge of Cost Sharing and Decisions to Seek Care (PDF | 297 KB)
American Journal of Managed Care. (2010). Knowledge of Cost Sharing and Decisions to Seek Care. Lischko, A. and Burgess, J.F.
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