Tiered cost sharing and health care demand

Ackley, Calvin A.

doi:10.1016/j.jhealeco.2022.102663

Cited by 4 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RAND HIE was not the only study that approached the relationship of cost-sharing and utilization of healthcare services. A paper published in 2022 by Ackley studied a tiered plan design to cost sharing using data from New Hampshire and specifically focusing on gastrointestinal endoscopic procedures (Ackley 2022). Ackley found that tiered plans did contribute to the reduction of mean spending by 4.5% on common gastrointestinal endoscopic procedures (Ackley 2022).…”

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

“…A paper published in 2022 by Ackley studied a tiered plan design to cost sharing using data from New Hampshire and specifically focusing on gastrointestinal endoscopic procedures (Ackley 2022). Ackley found that tiered plans did contribute to the reduction of mean spending by 4.5% on common gastrointestinal endoscopic procedures (Ackley 2022). Another major finding was that there was evidence to suggest that patients responded to tiered out-of-pocket prices but did not respond to traditional deductibles or coinsurance rate (Ackley 2022).…”

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

“…Ackley found that tiered plans did contribute to the reduction of mean spending by 4.5% on common gastrointestinal endoscopic procedures (Ackley 2022). Another major finding was that there was evidence to suggest that patients responded to tiered out-of-pocket prices but did not respond to traditional deductibles or coinsurance rate (Ackley 2022). Additionally, a systemic review conducted by Freeman et al in 2008 assesses the relationship between insurance and healthcare service utilization as well as health outcomes; this review is discussed in a later section.…”

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

“…Freeman et al's 2008 systemic review found a relationship between having more comprehensive insurance coverage and increased use of physician services; yet several studies within the review were unable to establish a consistent relationship between cost-sharing and hospital or emergency service utilization (Freeman et al 2008;Johnson and Crystal 2000;Sudano and Baker 2003;Trude 2003). Ackley (2022) shows that the utilization of care among patients undergoing gastrointestinal endoscopic procedures responded to tiered out-of-pocket prices but not to traditional deductibles or coinsurance rates (Ackley 2022). The question as to how health insurance impacts consumption of services in light of specific demographic factors is not addressed by the above studies.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Consumption of Healthcare Services in the United States: The Impact of Health Insurance

Narita

2023

JRFM

View full text Add to dashboard Cite

Over the past few decades, healthcare expenditures in the United States have increased due to a variety of different factors. Depending on their insurance plans, Americans have varying levels of health insurance coverage and may need to make co-payments or pay fully for specific health services. According to multiple studies, health insurance does appear to increase the utilization of healthcare services, except emergency services. Demographic factors such as age, citizenship, and race/ethnicity, as well as the type of health service demanded, all appear to influence the consumption of healthcare in the United States. However, many existing studies conducted in this area are not experimental or randomized, which may result in a lack of validity of the estimated relationship between insurance and healthcare utilization due to confounding variables. A new experimental study, similar to the RAND HIE study, is needed to provide insight into the current relationships between insurance and healthcare utilization, taking into consideration changes in legislation.

show abstract

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

Section: Rand Health Insurance Experimentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Consumption of Healthcare Services in the United States: The Impact of Health Insurance

Narita

2023

JRFM

View full text Add to dashboard Cite

show abstract

The Impact of Preferred Provider Incentives on Demand and Negotiated Prices

Ackley

2024

American Journal of Health Economics

View full text Add to dashboard Cite

Characteristics and spending patterns of high-cost child patients: findings from Fujian in China

Peng,

Guo

2024

BMC Public Health

View full text Add to dashboard Cite

Background The health condition during childhood has been shown to influence an individual’s health and socioeconomic status in adulthood. Understanding the concentration and persistence patterns in children’s healthcare expenditures is crucial for providing risk protection and promoting the well-being of children. Studies regarding the concentration and persistence of health expenditures have focused mainly on elderly individuals in developed regions. To gain insights into factors that contribute to childhood health expenditures, this article examined children with high costs (that is, in the top 10% of the expenditure distribution) and explored the characteristics and spending patterns that distinguished them from other patients in the context of the largest developing economy—China. Methods By using a unique individual-level administrative claims dataset over a 5-year observation period, this study identified spending concentrations and the proportion of children whose costs remained high over five years using a linear probability model and logit regression analysis. Results Teenagers from 12 to 17 years old were more likely to persist in the high-cost group than any other age groups in the study. Pediatric complex chronic conditions and other severe health ailments were predictive factors for entry into and persistence in the high-cost category. More than half of the total health expenditures were attributed to children in the top 10% expenditure group. In addition, risk protection and healthcare insurance support for high-cost children was found to be inadequate, particularly for children from low-income families. Conclusions Healthcare support for children impacts individual development and family financial status. This study described the characteristics and spending patterns of children patients in the largest developing country. The fact that over half of total expenditures are concentrated toward 10% of patients makes it valuable to consider relevant support for this group, especially for families whose medical costs are higher than income.

show abstract

Tiered cost sharing and health care demand

Cited by 4 publications

References 22 publications

Consumption of Healthcare Services in the United States: The Impact of Health Insurance

Consumption of Healthcare Services in the United States: The Impact of Health Insurance

The Impact of Preferred Provider Incentives on Demand and Negotiated Prices

Characteristics and spending patterns of high-cost child patients: findings from Fujian in China

Contact Info

Product

Resources

About