In a recent study, the Employee Benefits Research Institute examined the differential effect of copayments and coinsurance on health care services. They found that coinsurance reduces inpatient care and specialist physician office visits, but copayments do not. Specifically:
- For inpatient health care, each 1 percent increase in coinsurance led to a 0.18 percent decrease in utilization.
- For specialty physician office visits, each 1 percent increase in coinsurance led to a 0.19 percent decrease in utilization.
- Those who were more likely to want a telehealth visit but did not receive one were more likely to have an unmet need for care because of the pandemic.
- There was no evidence that demand for inpatient and specialty visits correlates with copayments.
Questions about how this can impact your employer group health insurance plan? Ask your Total Benefit Solutions, Inc account manager today at (215)355-02121