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Trends In Patient Cost Sharing For Hospital Care And Implications For Urban And Rural Hospital Revenue.

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Area of Science:

  • Health Economics
  • Healthcare Management
  • Health Services Research

Background:

  • Understanding evolving healthcare cost-sharing is crucial for financial stability of patients and providers.
  • Shifts in inpatient vs. outpatient care delivery influence financial pressures.
  • Commercial insurance claims data offer insights into cost-sharing trends.

Purpose of the Study:

  • To investigate changes in cost-sharing magnitudes and hospital collection shares.
  • To analyze the impact of healthcare delivery shifts on patient financial burdens.
  • To identify trends in cost-sharing composition over eleven years.

Main Methods:

  • Leveraged eleven years of commercial insurance claims data (2012-2022).
  • Analyzed the distribution of cost-sharing amounts owed by patients.
  • Examined the share of allowed healthcare costs anticipated as patient collections by hospitals.

Main Results:

  • Mean per enrollee spending and patient cost-sharing burdens grew substantially.
  • Cost sharing composition shifted towards high-cost and zero-cost encounters.
  • Utilization rates declined or remained stable during the study period.

Conclusions:

  • Patient cost-sharing burdens have increased, driven by high-deductible health plans and out-of-pocket maximums.
  • These trends may disproportionately impact rural hospitals due to higher patient-responsible revenue shares.
  • Hospitals may face greater challenges in collecting patient-owed revenue.