Despite the uncertainty about the future of the Affordable Care Act and what may replace it, it seems likely that more Americans will find themselves in health plans with patient cost sharing — high deductibles, copayments, or co-insurance — at the point of service.
A keen observation from Health Affairs:
Public debate about more limited insurance plans has mostly focused on their impact on beneficiaries. Missing from the discussion has been an analysis of how these plans could affect providers. Related research shows that each additional uninsured person costs hospitals $900 per year. While the effects of high-deductible health plans and other high cost-sharing policies are likely to be smaller, because they offer some coverage, the portion of beneficiaries facing high cost sharing could be large. Currently, little is known about how high cost sharing affects physician revenue.
The blanket assumption that the fiscal challenges of our health care system can be solely addressed by greater reliance on market forces, driven by less generous coverage, overlooks the many limits to such a strategy. Declining collection rates will limit the ability to shift costs to patients. While we must reduce costs overall, any replacements for the ACA must consider all the downstream implications of such cost-reduction efforts on both patients and providers. With a complete picture and full accounting of the interdependencies involved, policy makers and providers can take actions to counter potentially negative impacts with innovative solutions.