Patient cost-sharing innovations: promises and pitfalls.

Sally Trude, Joy M Grossman
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Abstract

Over the next decade, health plans and employers will refine patient cost sharing to encourage workers to seek more cost-effective care, according to a panel of market and health policy experts at a Center for Studying Health System Change (HSC) conference. Instead of using a single, large deductible, employers and health plans will likely vary patient cost sharing by choice of provider, site and type of service, so patients choosing less effective care options pay more. Employers also will try to limit financial hardships for low-income workers by, for example, varying cost sharing based on workers' income. However, significant obstacles could hinder the effectiveness of emerging cost-sharing strategies, including inadequate information on quality of care and provider resistance.

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病人费用分担创新:承诺与陷阱。
在医疗系统改革研究中心(HSC)会议上,一个由市场和卫生政策专家组成的小组表示,未来十年,医疗计划和雇主将改进患者的费用分担,以鼓励员工寻求更具成本效益的医疗服务。雇主和健康计划可能会根据提供者、地点和服务类型的选择来改变患者的费用分担,而不是使用单一的、高额的免赔额,因此,选择效果较差的护理方案的患者要支付更多的费用。雇主们还将试图限制低收入工人的经济困难,例如,根据工人的收入来分摊不同的成本。然而,重大障碍可能会阻碍新出现的费用分摊战略的有效性,包括关于护理质量的信息不足和提供者的抵制。
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Small employers and self-insured health benefits: too small to succeed? Employer-sponsored health insurance: down but not out. Rising hospital employment of physicians: better quality, higher costs? Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform. Physicians slow to e-mail routinely with patients.
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