Copays Kill!

Published on 06 February 2010 by echealth in Health Insurance Education

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In a surprising study to me, a recent study sponsored by Pfizer has shown that higher Medicare copayments for doctors leads to fewer doctor visits which leads to increased hospital visits both in time and frequency.

Copays seemingly go up every year, and hopefully insurers will take notice of this study as well, and do something about rocketing copayments.

The study had participation by nearly 900,000 seniors in 36 Medicare Advantage plans during 2001 to 2006.  Half of the plans raised their copays for office visits, and researchers were able to build statistical models which showed patterns of procrastination among the group in the higher copays.  Prescription drug coverage was not tested in the study, but if they were to study it, I can tell them the results.  Generics, Canada, and going without.

In the study, it seems that copays doubled from around $7 for the primary and $13 for the specialist to about $14 and $22 respectively, remember this is 2001 to 2006, and for the control group their copays stayed low at $8.33 at the primary and $11.38 at the specialist.

The results?  For every 100 people that enrolled in the plans that had increasing copays there were on average 20 fewer office visits but 2 additional hospital admissions and 13 more hospital days per year for this group then the control group.

The study also showed that the increases in copayments had the most profound effect on the poor and minorities in low income neighborhoods.

If you think about it the copayment system runs counter-intuitive to the entire idea of managed care, which is supposed to encourage preventative medicine.  Insurance Companies, I hope you are reading this.

2 Responses to “Copays Kill!”

  1. james johnson says:

    am trying to find out how much my copayment will be if i go into the sleep disorder center

  2. echealth says:

    depends on your plan and the company that insures you. Call us at 888 803 5917 for assistance.