Study: Higher copays could curb healthcare costs

To cut costs associated with expanding healthcare coverage, insurers should consider increasing copayments, concluded an article in the Journal of Health Economics.

The authors looked at thousands of people covered under the Massachusetts healthcare law and found that boosting copayments 10 percent from $20 to $30 would trim healthcare spending by 1.6 percent, according to a research announcement released Friday.

They attributed the drop in healthcare costs to greater patient cost-sharing mitigating the moral hazard, in which people engage in risky behaviors knowing insurance will pick up the tab. However, a November 2013 study published in the Journal of the American Board of Family Medicine debunked the moral hazard theory and found gain or loss of health insurance had no significant connection to changes in health habits, like smoking, weight gain and seat belt avoidance, FierceHealthPayer previously reported.

The authors noted that for low-income patients who can't move toward more appropriate utilization of healthcare services, small bumps in copayments could lead to poorer health and higher downstream costs.

That problem could occur within exchange plans that have high deductibles and copays, FierceHealthFinance previously reported. Moreover, data from the Centers for Disease Control and Prevention showed 34 percent of enrollees in higher-deductible health plans had difficulty paying medical bills, compared to 24 percent in plans with lower deductibles. 

In California, a new state law that requires insurers to cover autism therapy also shifts the payment of copayments and deductibles onto families, California Healthline reported. Largely thanks to the cost-shifting, almost 20 percent of families receiving autism therapy treatment at regional centers have canceled their children's health plans.

For more:
- here's the research announcement
- check out the study abstract
- read the California Healthline article

Suggested Articles

Drugs used for ventilator patients—such as sedatives and neuromuscular blockers—are running low.

Express Scripts saved its plan sponsors $4.3 billion last year through its slate of SafeGuardRx value-based care programs.

The COVID-19 pandemic is widening disparities in medication adherence between patient populations, which could have major health implications.