Featured Research

from universities, journals, and other organizations

Increased co-payments for doctor visits boost health-care costs for seniors

Date:
January 27, 2010
Source:
Brown University
Summary:
Researchers found that higher co-payments encouraged senior citizens to reduce their doctor visits, resulting in worsening illnesses and more expensive hospital care.

For years many health experts believed that increasing insurance co-payments for routine doctor visits helped control costs. Patients faced with the higher price tag, they theorized, would simply cut back unnecessary visits, saving themselves and insurers money.

Related Articles


Brown University researchers now believe that the practice of increasing co-payments for outpatient visits -- at least for senior citizens -- may actually make care far more expensive. They determined that patients faced with higher co-payments did cut back on their doctor visits. But those same elderly patients ultimately required expensive hospital care because their illnesses worsened.

The finding, to be detailed in the Jan. 28, 2010, edition of The New England Journal of Medicine, has implications for insurers and politicians seeking ways to control costs but also improve quality of care.

"It is a lose-lose proposition for most health plans," said Dr. Amal Trivedi, the study's lead author. "Our study suggests that when you raise co-payments for ambulatory care among elderly beneficiaries, particularly those with low incomes, lower education and chronic disease, they do cut back on their outpatient care but are more likely to need expensive hospital care." Trivedi is assistant professor of medical science in the Department of Community Health at Alpert Medical School.

The research findings are surprising, Trivedi said, because they counter long-standing thinking about health insurance and the effects of co-payments on patients' use of medical care and on their health. Studies from the early 1970s concluded that patients cut back on doctor visits when the cost of their insurance co-payments went up, but their health wasn't affected. Trivedi said the studies at that time did not include elderly patients.

For this study, Trivedi looked at Medicare data involving nearly 900,000 beneficiaries across the country. All were over age 65.

Trivedi and his team compared 18 Medicare plans with increased co-payments for outpatient care and 18 that offered similar coverage but had kept co-payments steady. The more expensive plans saw co-payments double for primary care, from $7.38 on average to $14.38, and from $12.66 to $22.05 for specialty care. For the plans where co-payments remained constant, those co-payments remained at $8.33 for primary care and $11.38 for specialty care.

During the following year, patients in health plans that increased co-payments reduced their visits to the doctor's office. But patients in these plans also had an increase in hospital admissions. By contrast, patients in health plans that maintained low co-payments had little change in hospital rates. Increased cost sharing led to nearly 20 fewer annual outpatient visits to the doctor's office per 100 enrollees. But annual hospital admissions grew by 2.2 per 100 enrollees. The higher price for outpatient care also led to 13.4 annual days in the hospital per 100 enrollees.

Trivedi and the other researchers found the effects of higher co-payments for outpatient care were particularly magnified among lower income senior citizens and among patients who had hypertension, diabetes or a history of heart problems.

The study "answers important questions," Trivedi said. "We have almost no data for elderly patients on the effect of increasing outpatient payments. Our study suggests that increasing these co-payments for the elderly is an ill-advised cost-containment strategy."

Trivedi said he hopes insurers use the data to reduce or at least not increase the amount of money Medicare beneficiaries must pay to see their doctors.

Trivedi conducted his study with graduate student Husein Moloo and Vincent Mor, chair of the Department of Community Health at Brown.

The research was funded by a Pfizer Health Policy Scholars Award and a career development award from the Veterans Affairs Health Services Research and Development Service.


Story Source:

The above story is based on materials provided by Brown University. Note: Materials may be edited for content and length.


Cite This Page:

Brown University. "Increased co-payments for doctor visits boost health-care costs for seniors." ScienceDaily. ScienceDaily, 27 January 2010. <www.sciencedaily.com/releases/2010/01/100127182454.htm>.
Brown University. (2010, January 27). Increased co-payments for doctor visits boost health-care costs for seniors. ScienceDaily. Retrieved January 28, 2015 from www.sciencedaily.com/releases/2010/01/100127182454.htm
Brown University. "Increased co-payments for doctor visits boost health-care costs for seniors." ScienceDaily. www.sciencedaily.com/releases/2010/01/100127182454.htm (accessed January 28, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, January 28, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Malnutrition on the Rise as Violence Flares in C. Africa

Malnutrition on the Rise as Violence Flares in C. Africa

AFP (Jan. 28, 2015) Violence can flare up at any moment in Bambari with only a bridge separating Muslims and Christians. Malnutrition is on the rise and lack of water means simple cooking fires threaten to destroy makeshift camps where people are living. Duration: 00:40 Video provided by AFP
Powered by NewsLook.com
Poultry Culled in Taiwan to Thwart Bird Flu

Poultry Culled in Taiwan to Thwart Bird Flu

Reuters - News Video Online (Jan. 28, 2015) Taiwan culls over a million poultry in efforts to halt various strains of avian flu. Julie Noce reports. Video provided by Reuters
Powered by NewsLook.com
Media Criticizing Parents For Not Vaccinating Children

Media Criticizing Parents For Not Vaccinating Children

Newsy (Jan. 28, 2015) As the Disneyland measles outbreak continues to spread, the media says parents who choose not to vaccinate their children are part of the cause. Video provided by Newsy
Powered by NewsLook.com
Shark Bite Victim Making Amazing Recovery

Shark Bite Victim Making Amazing Recovery

AP (Jan. 27, 2015) A Texas woman who lost more than five pounds of flesh to a shark in the Bahamas earlier this month could be released from a Florida hospital soon. Experts believe she was bitten by a bull shark while snorkeling. (Jan. 27) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins