"Cost sharing" from_date:2012

Cost Sharing for Preferred Branded Drugs in Medicare Part D. This study uses data from the Centers for Medicare & Medicaid Services Public Use Files to examine the use of co-payments and co-insurance for preferred brand-name drugs among Medicare Part D plans from 2020 to 2024 and characterize beneficiary exposure to these trends.

Association of State Insulin Out-of-Pocket Caps With Insulin Cost-Sharing and Use Among Commercially Insured Patients With Diabetes : A Pre-Post Study With a Control Group. Twenty-five states have implemented insulin out-of-pocket (OOP) cost caps, but their effectiveness is uncertain. To examine the effect of state insulin OOP caps on insulin use and OOP costs among commercially insured persons

Cost-sharing and associated factors in the Peruvian private health care system. The costs associated with healthcare are of critical importance to both decision-makers and users, given the limited resources allocated to the health sector. However, the available scientific evidence on healthcare costs in low- and middle-income countries, such as Peru, is scarce. In the Peruvian context , the health system is fragmented, and the private health insurance and its financing models have received less research attention. We aimed to analyse user cost-sharing and associated factors within the private healthcare system. Our study was cross-sectional, using open data from the Electronic Transaction Model of Standardized Billing Data-TEDEF-SUSALUD, between 2021-2022. Our unit of analysis

Impact of cost sharing on quality improvement and profits under uncertain demand: The case of a textile and garment supply chain. The study explores the strategic pricing and quality improvement decisions under uncertain demand in a three-layer textile and garment supply chain. According to whether the fabric manufacturer (FM) invests in quality or not and whether the garment manufacturer (GM ) or garment retailer (GR) is willing to share the costs or not, five game models are constructed to investigate the impact of different members' cost sharing on the optimal decisions and profits. By conducting a theoretical and numerical analysis, we find that: (1) The GM's or GR's cost sharing plays a positive effect on the quality improvement, as for whose cost sharing performs better in improving

Association Between Cost Sharing and Naloxone Prescription Dispensing. Increasing access to naloxone (an opioid antagonist that can reverse overdose) could slow the US opioid epidemic. Prior studies suggest cost sharing may be a barrier to dispensing of naloxone prescriptions, but these studies were limited by their cross-sectional designs and use of databases that do not capture prescriptions that are not filled (abandoned). To evaluate the association between cost sharing and naloxone prescription abandonment (nondispensing of naloxone prescriptions). This cross-sectional, regression discontinuity analysis exploited the fact that deductibles typically reset at the beginning of the year in commercial and Medicare plans. The included data were derived from the 2020-2021 IQVIA Formulary Impact Analyzer

Shingles Vaccination in Medicare Part D After Inflation Reduction Act Elimination of Cost Sharing. This cross-sectional study uses data from retail pharmacies to examine shingles vaccine uptake among Medicare Part D beneficiaries following an IRA policy to eliminate cost sharing.

Reduced Cost Sharing and Medication Management Services for COPD: A Randomized Clinical Trial High out-of-pocket costs and improper use of maintenance inhalers contribute to poor outcomes among patients with chronic obstructive pulmonary disease (COPD). There is limited evidence for how addressing these barriers could improve adherence and affect COPD exacerbations, spending, or racial disparities in these outcomes. To examine the effect of a national program to reduce beneficiary cost sharing for COPD maintenance inhalers and provide medication management services that included education on proper technique for inhaler use. This randomized clinical trial included individuals with COPD. All individuals were enrolled in Medicare Advantage. Data were collected from January 2019 to December

Association of Patient Cost-Sharing With Adherence to GLP-1a and Adverse Health Outcomes. To examine the associations between patient out-of-pocket (OOP) costs and nonadherence to glucagon-like peptide 1 receptor agonists (GLP-1a), and the consequent impact on adverse outcomes, including hospitalizations and emergency department (ED) visits. This retrospective cohort study used MarketScan

Cost sharing and protection mechanisms in health 2019 www.kce.fgov.be KCE REPORT 309 COST SHARING AND PROTECTION MECHANISMS IN HEALTH EXAMPLES OF HYPOTHETICAL SIMULATIONS: RESULTS 2019 www.kce.fgov.be KCE REPORT 309 HEALTH SERVICES RESEARCH COST SHARING AND PROTECTION MECHANISMS IN HEALTH EXAMPLES OF HYPOTHETICAL SIMULATIONS: RESULTS MARÍA-ISABEL FARFAN-PORTET, NICOLAS BOUCKAERT , STEPHAN DEVRIESE, CARL DEVOS, CARINE VAN DE VOORDE COLOPHON Title: Cost sharing and protection mechanisms in health Authors: María-Isabel Farfan-Portet (ex-KCE), Nicolas Bouckaert (KCE), Stephan Devriese (KCE), Carl Devos (KCE), Carine Van de Voorde (KCE) Project coordinator: Nathalie Swartenbroekx (KCE) External experts: Brigitte Dormont (Université Paris Dauphine), Erik Schokkaert (KU

Episode-Based Cost Sharing to Prospectively Guarantee Patients' Out-of-Pocket Costs. This Viewpoint proposes episode-based cost sharing as a way to prospectively guarantee out-of-pocket costs for patients while also preventing insurers from absorbing cost differentials created by unexpected complications of care.

Why Cost Sharing on Its Own Will Not Fix Health Care Costs. This Viewpoint describes issues with cost sharing for health care costs and suggests improvements to current cost sharing systems.

Collaborative Care Cost-Sharing and Referral Rates in Colorado. Collaborative care integrates mental health treatment into primary care and has been shown effective. Yet even in states where its use has been encouraged, take-up remains low and there are potential financial barriers to care. Describe patient out-of-pocket costs and variations in referral patterns for collaborative care

A structural microsimulation model for demand-side cost-sharing in healthcare. Demand-side cost-sharing reduces moral hazard in healthcare but increases exposure to out-of-pocket expenditure. We introduce a structural microsimulation model to evaluate both total and out-of-pocket expenditure for different cost-sharing schemes. We use a Bayesian mixture model to capture the healthcare expenditure

Association Between Cost-Sharing and Buprenorphine Prescription Abandonment. Prior studies suggest cost-sharing decreases buprenorphine dispensing. However, these studies used databases that only report prescriptions filled by patients, not those that were "abandoned." Consequently, the studies could not calculate the probability of buprenorphine prescription abandonment or evaluate whether cost -sharing is associated with abandonment. To evaluate the association between cost-sharing and buprenorphine prescription abandonment. Cross-sectional analysis of the IQVIA Formulary Impact Analyzer, a pharmacy transaction database representing 63% of U.S. retail pharmacies. The database includes transaction records ("claims") for prescriptions even if they are not filled. Buprenorphine claims in 2022

Short-term effects of reduced cost sharing on childhood dental care utilization and dental caries prevention in Japan. Generous dental insurance coverage can improve oral health among children. However, most previous studies were from the United States, and the results may not be applicable to countries with universal healthcare systems. The purpose of the present study was to examine the effect

Patient Cost-Sharing and Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After a Screening Mammogram. Out-of-pocket costs (OOPCs) have been largely eliminated for screening mammography. However, patients still face OOPCs when undergoing subsequent diagnostic tests after the initial screening, which represents a potential barrier to those who require follow-up testing after initial testing. To examine the association between the degree of patient cost-sharing and the use of diagnostic breast cancer imaging after undergoing a screening mammogram. This retrospective cohort study used medical claims from Optum's deidentified Clinformatics Data Mart Database, a commercial claims database derived from a database of administrative health claims

Emergency Department Use Across Income Groups Following an Increase in Cost-Sharing. To encourage the appropriate utilization of emergency care, cost-sharing for emergency care was increased from HK$100 (US $12.8) to HK$180 (US $23.1) per visit in June 2017 in all public hospitals in Hong Kong. However, there are concerns that this increase could deter appropriate emergency department (ED

Policy implications of heterogeneous demand reactions to changes in cost-sharing: Patient-level evidence from Austria. Cost-sharing is a prominent tool in many healthcare systems, both for raising revenue and steering patient behaviour. Although the effect of cost-sharing on demand for healthcare services has been heavily studied in the literature, researchers often apply a macro-perspective (+1.4%) or both (+1.6%) and for which patients also postponed their consumption until after the cost-sharing reduction. In contrast, we do not find a clear demand reaction for inexpensive or urgent services. The detailed analysis of the demand reaction for each individual healthcare service further illustrates their heterogeneity. We show that even comparatively minor changes to the costs borne

Tiered cost sharing and health care demand. In this paper, I study tiered cost sharing, an innovative incentive structure designed to steer patients toward low-cost providers using large out-of-pocket price differentials. Using administrative data from New Hampshire, where two large insurers utilize tiered pricing programs, I estimate the effects of tiering on choices and spending for common

Utilization Impact of Cost-Sharing Elimination for Preventive Care Services: A Rapid Review. Consumer cost-sharing has been shown to diminish utilization of preventive services. Recent efforts, including provisions within the Affordable Care Act, have sought to increase use of preventive care through elimination of cost-sharing for clinically indicated services. We conducted a rapid review of the literature to determine the impact of cost-share elimination on utilization of preventive services. Searches were conducted in PubMed, Scopus, and CINAHL Complete databases as well as in grey literature. A total of 35 articles were included in qualitative synthesis and findings were summarized for three clinical service categories: cancer screenings, contraceptives, and additional services. Impacts of cost