Higher copays raise health costs in U.S. aged: study
The research,
published in the New England Journal of Medicine, questions the wisdom of
raising co-payments to save money, at least among the elderly.
That might be a way
to cut health care costs among younger people, but not for people age 65 and
older, Dr. Amal Trivedi of Brown University, who led the study, said in a
telephone interview.
"It's a
lose-lose proposition for most health plans," Trivedi said.
Older people
"have more medical conditions, they spend more on health care, and they
usually are on fixed incomes, so they're much more sensitive to the
co-payments. And our study suggests that raising co-payments for the elderly
would be counterproductive," he said.
Co-payments are the
portion of healthcare paid for by the patient and are a way of sharing expenses
between patients and insurers.
Trivedi's team
studied nearly 900,000 people enrolled in 36 different plans under Medicare,
the federal health insurance plan for the elderly and disabled. Half of the
plans raised co-payments during the study period from 2001 through 2006.
Enrollees in plans
whose co-pays for a trip to a specialist nearly doubled to $22 had a
hospitalization rate that was 8.7 percent higher than among people whose
copayments remained unchanged, averaging $11.38.
"We estimate
that the average health plan, for every 100 enrollees, would gain $7,150 from
collecting more co-payments and from decreased use of outpatient services, but
that same plan would spend approximately $24,000 in additional hospital
expenses because care in the hospital is so expensive," said Trivedi.
"Perhaps plans
should seriously consider reducing co-payments," he said.
Requiring
co-payments turned out to be especially costly to insurance companies when
their subscribers were poor, poorly educated, black or had underlying health
problems like diabetes, high blood pressure and a history of heart attack.
Those are the
people whose decision to seek treatment was the most sensitive to the increased
co-pays, said Trivedi.
Between 2001 and
2006, the typical co-payment for an office visit doubled under employer-based
health plans.
Source: reuters.com