Monthly Cost-Sharing Limits and Out-of-pocket Costs for Commercially Insured Patients in the US

Author:

Shafer Paul R.1,Horný Michal2,Dusetzina Stacie B.3

Affiliation:

1. Department of Health Law, Policy, and Management, School of Public Health, Boston University, Boston, Massachusetts

2. Department of Radiology and Imaging Sciences, School of Medicine, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia

3. Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee

Abstract

This cross-sectional study assesses how much monthly cost-sharing limits, as opposed to annual limits, could reduce out-of-pocket costs for commercially insured patients in the US.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Reference6 articles.

1. Rae? M, Claxton? G, Levitt? L. Do health plan enrollees have enough money to pay cost sharing? Kaiser Family Foundation. November 3, 2017. Accessed November 16, 2021. https://www.kff.org/health-costs/issue-brief/do-health-plan-enrollees-have-enough-money-to-pay-cost-sharing/

2. Shafer? PR, Horný? M, Dusetzina? SB. Rethinking annual deductibles: the case for monthly cost-sharing limits. Health Affairs Blog. October 16, 2020. Accessed August 12, 2022. https://www.healthaffairs.org/do/10.1377/forefront.20201013.566424/

3. Kearney? M, Hamel? L, Stokes? M, Brodie? M. Americans’ challenges with health care costs. Kaiser Family Foundation. December 14, 2021. Accessed May 3, 2022. https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

4. Chandra? A, Flack? E, Obermeyer? Z. The health costs of cost-sharing. National Bureau of Economic Research Working Paper Series, No. 28439. National Bureau of Economic Research; 2021. doi:10.3386/w28439

5. IBM Watson Health. IBM MarketScan Research Databases for life sciences researchers. July 2021. Accessed July 14, 2022. https://www.ibm.com/downloads/cas/OWZWJ0QO

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