The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente

Abstract

Most hospitals have financial assistance programs for low-income patients. We use administrative data from Kaiser Permanente to study the effects of financial assistance on health care utilization. Using a regression discontinuity design based on an income threshold for program eligibility, we find that financial assistance increases the likelihood of inpatient, ambulatory, and emergency department encounters by 3.6 pp (59 percent), 13.4 pp (20 percent), and 6.7 pp (53 percent), respectively, though effects dissipate three quarters after program receipt. Financial assistance also increases the detection and management of treatment-sensitive conditions (e.g., drugs treating diabetes), suggesting that financial assistance may increase receipt of high-value care. (JEL G51, I11, I12, I13, I32)