“Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”
Abstract Background Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and health care rationing among low-income Medicare beneficiaries. The obje...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-3982-8 |
| _version_ | 1818997959807729664 |
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| author | Jennifer N. Goldstein J. Sanford Schwartz Patricia McGraw LeRoi S. Hicks |
| author_facet | Jennifer N. Goldstein J. Sanford Schwartz Patricia McGraw LeRoi S. Hicks |
| author_sort | Jennifer N. Goldstein |
| collection | DOAJ |
| description | Abstract Background Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and health care rationing among low-income Medicare beneficiaries. The objective of this study was to explore the potential impact of observation cost-sharing on future medical decision making of Medicare beneficiaries. Methods Single-center pilot cohort study. A convenience sample of Medicare beneficiaries hospitalized under observation status care was surveyed. Results Out of 144 respondents, low-income beneficiaries were more likely to be concerned about the cost of their observation stay than higher-income respondents (70.7% vs29.3%, p = 0.015). If hospitalized under observation status again, there was a trend among low-income beneficiaries to request completion of their workup outside of the hospital (56.3% vs 43.8%), and to consider leaving against medical advice (AMA) (100% vs 0%), though these trends were not statistically significant (p = 0.30). Conclusion The results of this pilot study suggest that low-income Medicare beneficiaries hospitalized under observation status have greater concerns about their cost-sharing obligations than their higher income peers. Cost-sharing for observation care may have unintended consequences on utilization for low-income beneficiaries. Future studies should examine this potential relationship on a larger scale. |
| first_indexed | 2024-12-20T21:53:55Z |
| format | Article |
| id | doaj.art-f0d2043d0ba94ce2a42d0b0be829c6b3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-20T21:53:55Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f0d2043d0ba94ce2a42d0b0be829c6b32022-12-21T19:25:29ZengBMCBMC Health Services Research1472-69632019-03-011911510.1186/s12913-019-3982-8“Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”Jennifer N. Goldstein0J. Sanford Schwartz1Patricia McGraw2LeRoi S. Hicks3Department of Medicine & The Value Institute, Christiana Care Health SystemDivision of General Internal Medicine, University of PennsylvaniaDepartment of Medicine & The Value Institute, Christiana Care Health SystemDepartment of Medicine & The Value Institute, Christiana Care Health SystemAbstract Background Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and health care rationing among low-income Medicare beneficiaries. The objective of this study was to explore the potential impact of observation cost-sharing on future medical decision making of Medicare beneficiaries. Methods Single-center pilot cohort study. A convenience sample of Medicare beneficiaries hospitalized under observation status care was surveyed. Results Out of 144 respondents, low-income beneficiaries were more likely to be concerned about the cost of their observation stay than higher-income respondents (70.7% vs29.3%, p = 0.015). If hospitalized under observation status again, there was a trend among low-income beneficiaries to request completion of their workup outside of the hospital (56.3% vs 43.8%), and to consider leaving against medical advice (AMA) (100% vs 0%), though these trends were not statistically significant (p = 0.30). Conclusion The results of this pilot study suggest that low-income Medicare beneficiaries hospitalized under observation status have greater concerns about their cost-sharing obligations than their higher income peers. Cost-sharing for observation care may have unintended consequences on utilization for low-income beneficiaries. Future studies should examine this potential relationship on a larger scale.http://link.springer.com/article/10.1186/s12913-019-3982-8Healthcare policyPovertyPublic policyAccess to and utilization of healthcareDisparities |
| spellingShingle | Jennifer N. Goldstein J. Sanford Schwartz Patricia McGraw LeRoi S. Hicks “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” BMC Health Services Research Healthcare policy Poverty Public policy Access to and utilization of healthcare Disparities |
| title | “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” |
| title_full | “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” |
| title_fullStr | “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” |
| title_full_unstemmed | “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” |
| title_short | “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey” |
| title_sort | implications of cost sharing for observation care among medicare beneficiaries a pilot survey |
| topic | Healthcare policy Poverty Public policy Access to and utilization of healthcare Disparities |
| url | http://link.springer.com/article/10.1186/s12913-019-3982-8 |
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