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Patient Cost Share for Emergency Physician Servcies During the COVID-19 Pandemic

Bing Shih Pao1, Theodore Craig Chan1

  • 1Department of Emergency Medicine, University of California, San Diego, San Diego, California.

The Journal of Emergency Medicine
|October 14, 2022
PubMed

Insights

Patient cost-sharing waivers for COVID-19 emergency care significantly reduced patient expenses for emergency physician services. These waivers were effective in lowering out-of-pocket costs for COVID-19 related emergency visits.

Area of Science:

  • Health Economics
  • Public Health Policy
  • Emergency Medicine

Background:

  • The COVID-19 pandemic prompted health plans to implement patient cost-share waivers for emergency care.
  • The financial impact of these waivers on patients for emergency physician services remained unquantified.

Purpose of the Study:

  • To assess the effect of COVID-19 cost-sharing waivers on patient expenses for emergency physician services.
  • To compare patient cost-shares for COVID-19 versus non-COVID-19 emergency care during the pandemic.

Main Methods:

  • A retrospective review of commercial claims from 77 California emergency departments was performed.
  • Claims data from a 9-month prepandemic period (2019) were compared to a 9-month pandemic period (2020).
  • Analysis focused on changes in patient cost-share for emergency physician services, differentiating between COVID-19 and non-COVID-19 related care.

Main Results:

  • The average patient cost-share for COVID-19 related emergency physician care was $19, compared to $52 for non-COVID-19 care.
  • Patient cost-share was 63% lower for COVID-19 related emergency care than for non-COVID-19 care.
  • A minimal increase (less than $2) in patient cost-share for non-COVID-19 emergency care was observed during the pandemic.

Conclusions:

  • Health plan payment policies effectively reduced patient cost-share for COVID-19 related emergency physician services.
  • The waivers demonstrated a significant positive financial impact for patients seeking emergency care during the pandemic.
Abstract

Keywords:
COVID-19 emergency careEmergency physician professional servicesPatient cost share waivers

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