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Reference-Based Benefits for Colonoscopy and Arthroscopy: Large Differences in Patient Payments Across Procedures but Similar Behavioral Responses.
- Source :
-
Medical care research and review : MCRR [Med Care Res Rev] 2020 Jun; Vol. 77 (3), pp. 261-273. Date of Electronic Publication: 2018 Aug 13. - Publication Year :
- 2020
-
Abstract
- This study examines how reference-based benefits (RBB) affect patient out-of-pocket payments across outpatient procedures. The California Public Employees' Retirement System (CalPERS) implemented RBB asymmetrically for outpatient procedures in 2012, only applying RBB to outpatient procedures performed in a hospital outpatient department (HOPD), and not applying RBB to outpatient procedures performed in a lower cost ambulatory surgery center. Using claims data (2009-2013) on arthroscopy and colonoscopy services, we found that for colonoscopy, CalPERS patients paid an average of 63.9% ( p < .01) more for HOPDs than ambulatory surgery centers in 2012. For arthroscopy, no statistically different cost sharing was found on average. However, high-priced HOPDs were 17.3% and 17.9% less likely to be chosen by CalPERS patients in 2012 for colonoscopy and arthroscopy, respectively. These magnitudes increased in 2013 to 25.2% and 24.2% less, respectively. Overall, responsiveness to RBB with regard to the most expensive HOPDs was similar despite varying cost sharing by procedure.
- Subjects :
- California
Female
Hospitals
Humans
Male
Middle Aged
Ambulatory Surgical Procedures statistics & numerical data
Arthroscopy economics
Arthroscopy statistics & numerical data
Colonoscopy economics
Colonoscopy statistics & numerical data
Cost Sharing
Health Expenditures statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1552-6801
- Volume :
- 77
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Medical care research and review : MCRR
- Publication Type :
- Academic Journal
- Accession number :
- 30103654
- Full Text :
- https://doi.org/10.1177/1077558718793325