The Increasing Adoption of Out-of-Pocket Cost Caps

Author:

Wharam J. Frank12,Rosenthal Meredith B.3

Affiliation:

1. Department of Medicine, Duke University, Durham, North Carolina

2. Duke-Margolis Center for Health Policy, Durham, North Carolina

3. Harvard School of Public Health, Boston, Massachusetts

Abstract

This Viewpoint discusses potential benefits and unintended consequences of out-of-pocket cost caps in Medicare and the employer-sponsored health insurance market and provides suggested policy opportunities to address shortcomings.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Reference7 articles.

1. The growing problem of out-of-pocket costs and affordability in employer-sponsored insurance.;Rosenthal;JAMA,2021

2. Value-based insurance design: a “clinically sensitive” approach to preserve quality of care and contain costs.;Fendrick;Am J Manag Care,2006

3. Diabetes outpatient care and acute complications before and after high-deductible insurance enrollment: a natural experiment for translation in diabetes (NEXT-D) study.;Wharam;JAMA Intern Med,2017

4. Freed? M, Cubanski? J, Damico? A, Neuman? T. Help with Medicare premium and cost-sharing assistance varies by state. KFF. April 20, 2022. Accessed December 30, 2022. https://www.kff.org/medicare/issue-brief/help-with-medicare-premium-and-cost-sharing-assistance-varies-by-state/

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