Increased patient cost-sharing may hurt elderly

http://news.yahoo.com/s/ap/20100127/ap_on_he_me/us_med_medicare_costs;_ylt=AkKgc5D7CYtxQunOZKOK2Vqs0NUE;_ylu=X3oDMTFkcmZnZmZlBHBvcwMxNDgEc2VjA2FjY29yZGlvbl9oZWFsdGgEc2xrA2luY3JlYXNlZHBhdA--

By ALICIA CHANG, AP Science Writer Alicia Chang, Ap Science Writer – Wed Jan 27, 5:00 pm ET

LOS ANGELES – Higher Medicare copays, sometimes just a few dollars more, led to fewer doctors visits and to more and longer hospital stays, a large new study reveals.

With health care costs skyrocketing, many public and private insurers have required patients to pay more out-of-pocket when they seek care. The new study confirms what many policymakers had feared: cost-shifting moves can backfire.

"Patients may defer needed care and may wind up with a serious health event that might put them in the hospital. That's not good for the patients, not good for society, not good for anybody," said Dr. Tim Carey, who heads the University of North Carolina's Sheps Center for Health Services Research.

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For every 100 people enrolled in plans that raised copays, there were 20 fewer doctor visits, 2 additional hospital admissions and 13 more days spent in the hospital in the year after the increase compared to those in plans whose copays did not change, researchers found.

The trend was most pronounced among blacks, people living in lower-income neighborhoods and those with chronic illnesses such as diabetes, high blood pressure or heart disease.

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The findings echo previous studies on increased patient cost-sharing. When California's Medicaid program introduced a $1 copay in 1972, it led to an 8 percent decline in doctor visits and a 17 percent increase in hospital days.