Cost-sharing: A blunt instrument

Annual Review of Public Health

Volumn 30, Issue , 2009, Pages 293-311

  Remler, Dahlia K ^a,b   Greene, Jessica ^c  

^a CITY UNIVERSITY OF NEW YORK   (United States)

^b CITY UNIVERSITY OF NEW YORK   (United States)

^c UNIVERSITY OF OREGON   (United States)

Author keywords

Access; Consumer driven health plans; Cost containment; Cost effective care; Health insurance

Indexed keywords

ANTIDIABETIC AGENT; ANTIHYPERTENSIVE AGENT; BRONCHODILATING AGENT;

COST EFFECTIVENESS ANALYSIS; DRUG COST; EMERGENCY WARD; ETHNICITY; GROUPS BY AGE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HEALTH SERVICE; HEALTH STATUS; HUMAN; MEDICAL CARE; MEDICAL DECISION MAKING; PATIENT CARE; PRIORITY JOURNAL; RACE DIFFERENCE; REVIEW; SEX DIFFERENCE;

COST CONTROL; COST SHARING; DELIVERY OF HEALTH CARE; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS; HUMANS; INSURANCE, HEALTH; PHARMACIES; PREVENTIVE HEALTH SERVICES; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 67650744859     PISSN: 01637525     EISSN: None     Source Type: Book Series    
DOI: 10.1146/annurev.publhealth.29.020907.090804     Document Type: Review

References (64)

1. Anderson GF, Reinhardt UE, Hussey PS, Petrosyan V. 2003. It's the prices, stupid: Why the United States is so different from other countries. Health Aff. (Project Hope) 22:89-105
2. Atherly A. 2001. Supplemental insurance: Medicare's accidental stepchild. Med. Care Res. Rev. 58:131-61
3. Bloche MG. 2007. Consumer-directed health care and the disadvantaged. Health Aff. 26:1315-27
4. Buntin MB, Damberg C, Haviland A, Kapur K, Lurie N, et al. 2006. Consumer-directed health care: early evidence about effects on cost and quality. Health Aff. 25:w516-30
5. Busch SH, Barry CL, Vegso SJ, Sindelar JL, Cullen MR. 2006. Effects of a cost-sharing exemption on use of preventive services at one large employer. Health Aff. (Millwood) 25:1529-36
6. Chandra A, Gruber J, McKnight R. 2007. Patient cost-sharing, hospitalization offsets, and the design of optimal health insurance for the elderly. Work. Pap. 12972, Natl. Bur. Econ. Res.
7. Cherkin DC, Grothaus L, Wagner EH. 1989. The effect of office visit copayments on utilization in a health maintenance organization. Med. Care 27:1036-45
8. Cherkin DC, Grothaus L, Wagner EH. 1990. The effect of office visit copayments on preventive care services in an HMO. Inquiry 27:24-38
9. Cherkin DC, Grothaus L, Wagner EH. 1992. Is magnitude of copayment effect related to income? Using census data for health services research. Soc. Sci. Med. 34:33-41
10. Chernew ME, Rosen AB, Fendrick AM. 2007. Value-based insurance design. Health Aff. (Project Hope) 26:w195-203
11. Chernew ME, Shah MR, Wegh A, Rosenberg SN, Juster IA, et al. 2008. Impact of decreasing copayments on medication adherence within a disease management environment. Health Aff. (Millwood) 27:103-12
12. Claxton G, DiJulio B, Finder B, Becker E, Hawkins S, et al. 2007. Employer Health Benefits: 2007 Annual Survey. Menlo Park, CA: Henry J. Kaiser Family Found. Health Res. Educ. Trust
13. Deficit Reduction Act of 2005. 2006. Public Law 109-171, 109th Cong., Feb. 8
14. Feldman R, Parente ST, Christianson JB. 2007. Consumer-directed health plans: new evidence on spending and utilization. Inquiry 44:26-40
15. Fendrick AM, Chernew ME. 2007. "Fiscally responsible, clinically sensitive" cost sharing: contain costs while preserving quality. Am. J. Manag. Care 13:325-27
16. Frank RG. 2004. Behavioral economics and health economics. Work. Pap. 10881, Natl. Bur. Econ. Res.
17. Frank RG, Garfield RL. 2007. Managed behavioral health care carve-outs: past performance and future prospects. Annu. Rev. Public Health 28:303-20
18. Fuchs VR. 2002. What's ahead for health insurance in the United States? N. Engl. J. Med. 346:1822-24
19. Gaynor M, Li J,Vogt WB.2006. Is drug coverage a free lunch? Cross-price elasticities and the design of prescription drug benefits. Work. Pap. 07/166, Dep. Econ., Cent. Mark. Public Organ., Univ. Bristol
20. Gibson TB, Ozminkowski RJ, Goetzel RZ. 2005. The effects of prescription drug cost sharing: a review of the evidence. Am. J. Manag. Care 11:730-40
21. Glied S, Cuellar A. 2006. Better behavioral health care coverage for everyone. N. Engl. J. Med. 354:1415-17
22. Goldman DP, Joyce GF, Karaca-Mandic P. 2006. Varying pharmacy benefits with clinical status: the case of cholesterol-lowering therapy. Am. J. Manag. Care 12:21-28
23. Goldman DP, Joyce GF, Zheng Y. 2007. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA 298:61-69
24. Greene J, Hibbard J, Murray J, Teutsch S, Berger M. 2008. The impact of consumer directed health plans on prescription drug utilization. Health Aff. 27(4):1111-19
25. Greene J, Hibbard JH, Dixon A, Tusler M. 2006. Which consumers are ready for consumer-directed health plans? J. Consum. Policy 29:247-62
26. Greene J, Peters E, Mertz CK, Hibbard JH. 2008. Comprehension and choice of a consumer-directed health plan: An experimental study. Am. J. Manag. Care 14(6):369-76
27. Hakim D. 2005. G.M. and union strike deal on health costs. New York Times, Oct. 17: http://www. nytimes.com/2005/10/17/business/18cnd-GM. html?pagewanted=1&-r=1
28. Heisler M, Langa KM, Eby EL, Fendrick AM, Kabeto MU, Piette JD. 2004. The health effects of restricting prescription medication use because of cost. Med. Care 42:626-34
29. Hibbard J, Greene J, Tusler M. 2008. Does enrollment in a CDHP stimulate cost-effective utilization? Med. Care Res. Rev. 65(4):437-49
30. Hodgkin D, Horgan CM, Garnick DW,Merrick EL. 2003. Cost sharing for substance abuse and mental health services in managed care plans. Med. Care Res. Rev. 60:101-16
31. Hsu J, Price M, Brand R, Ray GT, Fireman B, et al. 2006. Cost-sharing for emergency care and unfavorable clinical events: findings from the safety and financial ramifications of ED copayments study. Health Serv. Res. 41:1801-20
32. Karter AJ, Stevens MR, Herman WH, Ettner S, Marrero DG, et al. 2003. Out-of-pocket costs and diabetes preventive services: the translating research into action for diabetes (TRIAD) study. Diabetes Care 26:2294-99
33. Khan N, Kaestner R, Lin SJ. 2007. Prescription drug insurance and its effect on utilization and health of the elderly. Work. Pap. 12848, Natl. Bur. Econ. Res.
34. Kolata G. 2008. Co-payments for drugs soar for drugs with high prices. New York Times, Oct. 17:http://www.nytimes.com/2005/10/17/business/ 18cnd-GM.html?pagewanted=1&-r=1
35. Lo Sasso AT, Lindrooth RC, Lurie IZ, Lyons JS. 2006. Expanded mental health benefits and outpatient depression treatment intensity. Med. Care 44:366-72
36. Lo Sasso AT, Lyons JS. 2002. The effects of copayments on substance abuse treatment expenditures and treatment reoccurrence. Psychiatr. Serv. 53:1605-11
37. Magid DJ, Koepsell TD, Every NR,Martin JS, Siscovick DS, et al. 1997. Absence of association between insurance copayments and delays in seeking emergency care among patients with myocardial infarction. N. Engl. J. Med. 336:1722-29
38. Mechanic D. 2002. Removing barriers to care among persons with psychiatric symptoms. Health Aff. 21:137-47
39. Newhouse J. 1993. Free for All? Lessons from the RAND Health Insurance Experiment. Cambridge, MA: Harvard Univ. Press
40. Nyman JA. 2003. The Theory of Demand for Health Insurance. Stanford, CA: Stanford Univ. Press, Stanford Econ. Financ. xiv pp.
41. Nyman JA. 2007. American health policy: cracks in the foundation. J. Health Polit. Policy Law 32:759-83
42. Pai CW, Ozcan YA, Jiang HJ. 2000. Regional variation in physician practice pattern: an examination of technical and cost efficiency for treating sinusitis. J. Med. Syst. 24:103-17
43. Parente ST, Feldman R, Christianson JB. 2004. Evaluation of the effect of a consumer-driven health plan on medical care expenditures and utilization. Health Serv. Res. 39(Pt. 2):1189-210
44. Pollack C, Mallya G, Polsky D. 2008. The impact of consumer-directed health plans and patient socioeconomic status on physician recommendations for colorectal cancer screening. J. Gen. Intern. Med. 23(10):1595-601
45. Remler DK, Atherly AJ. 2003. Health status and heterogeneity of cost-sharing responsiveness: How do sick people respond to cost-sharing? Health Econ. 12:269-80
46. Remler DK, Glied SA. 2006. How much more cost-sharing will health savings accounts bring? Health Aff. 25:1070-78
47. Rice T. 2003. The impact of cost containment efforts on racial and ethnic disparities in healthcare: a conceptualization. In Unequal Treatment, ed. B Smedley, A Stith, A Nelson, pp. 699-721. Washington, DC: Natl. Acad. Press
48. Rice T, Thorpe KE. 1993. Income-related cost sharing in health insurance. Health Aff. (Millwood) 12:21-39
49. Roddy PC, Wallen J, Meyers SM. 1986. Cost sharing and use of health services. The United Mine Workers of America Health Plan. Med. Care 24:873-76
50. Rowe JW, Brown-Stevenson T, Downey RL, Newhouse JP. 2008. The effect of consumer-directed health plans on the use of preventive and chronic illness services. Health Aff. 27:113-20
51. Scheffler RM. 1984. The United Mine Workers' Health Plan: an analysis of the cost-sharing program. Med. Care 22:247-54
52. Selby JV, Fireman BH, Swain BE. 1996. Effect of a copayment on use of the emergency department in a health maintenance organization. N. Engl. J. Med. 334:635-41
53. Simon GE, Grothaus L, Durham ML, VonKorff M, Pabiniak C. 1996. Impact of visit copayments on outpatient mental health utilization by members of a health maintenance organization. Am. J. Psychiatry 153:331-38
54. Solanki G, Schauffler HH. 1999. Cost-sharing and the utilization of clinical preventive services. Am. J. Prev. Med. 17:127-33
55. Stein B, Orlando M, Sturm R. 2000. The effect of copayments on drug and alcohol treatment following inpatient detoxification under managed care. Psychiatr. Serv. 51:195-98
56. Steinman MA, Sands LP, Covinsky KE. 2001. Self-restriction of medications due to cost in seniors without prescription coverage. J. Gen. Intern. Med. 16:793-99
57. Stuart B, Zacker C. 1999. Who bears the burden of Medicaid drug copayment policies? Health Aff. (Project Hope) 18:201-12
58. Tamblyn R, Laprise R, Hanley JA, Abrahamowicz M, Scott S, et al. 2001. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA 285:421-29
59. Trivedi AN, Rakowski W, Ayanian JZ. 2008. Effect of cost sharing on screening mammography in Medicare health plans. N. Engl. J. Med. 358:375-83
60. Wallen J, Roddy P, Meyers SM. 1986. Male-female differences in mental health visits under cost-sharing. Health Serv. Res. 21(Pt. 2):341-50
61. Wharam JF, Landon BE, Galbraith AA, Kleinman KP, Soumerai SB, Ross-Degnan D. 2007. Emergency department use and subsequent hospitalizations among members of a high-deductible health plan. J. Am. Med. Assoc. 297:1093-102
62. Wickizer TM, Lessler D. 2002. Utilization management: issues, effects, and future prospects. Annu. Rev. Public Health 23:233-54
63. Yu WW, Ezzati-Rice TM. 2005. Concentration of health care expenditures in the U.S. civilian noninstitutionalized population. Stat. Brief #81. Agency Healthc. Res. Quality, Rockville, MD. http://meps.ahrq. gov/mepsweb/data files/publications/st81/stat81.pdf
64. Zeber JE, Grazier KL, Valenstein M, Blow FC, Lantz PM. 2007. Effect of a medication copayment increase in veterans with schizophrenia. Am. J. Manag. Care 13:335-46