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Patient cost-sharing innovations: promises and pitfalls.
Issue Brief (Center for Studying Health System Change)
|February 24, 2004
Summary
Health plans and employers will adjust patient cost sharing to promote cost-effective care. Strategies include varying costs by provider and income, but quality data gaps and provider resistance pose challenges.
Area of Science:
- Health Policy
- Healthcare Economics
- Health Services Research
Background:
- Employers and health plans are exploring new patient cost-sharing models.
- Current models may not adequately incentivize cost-effective care choices.
Purpose of the Study:
- To outline emerging patient cost-sharing strategies.
- To identify potential obstacles to these strategies' effectiveness.
Main Methods:
- Expert panel discussion at a Center for Studying Health System Change (HSC) conference.
- Analysis of projected trends in health plan and employer benefit design.
Main Results:
- Future cost-sharing will likely vary by provider, service type, and patient income.
- Strategies aim to guide patients toward more cost-effective options.
- Potential barriers include lack of quality data and provider opposition.
Conclusions:
- Evolving cost-sharing models aim for efficiency and equity.
- Overcoming information and provider-related hurdles is crucial for success.