What are the Implications of Instituting Copayments and Premium Cost-Sharing?

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Implications of Instituting Copayments and Premium Cost-Sharing

At the SCHIP Workshop held in Sanibel Island, Florida, on June 29-July 1, 1998, Judith Arnold talked about the implication of instituting copayments and premium cost-sharing. The following represents information taken from Ms. Arnold's presentation.

Instituting cost-sharing may benefit a State health program by:

Deterring unnecessary utilization of services.

Encouraging personal responsibility.

Defraying the government share of cost for subsidized health care coverage.

Reducing substitution of private coverage (crowd-out).

However, common concerns regarding instituting cost-sharing are:

Reduced enrollment as an effect of premiums that are perceived as too costly.

Reduced utilization of needed services resulting from unaffordable copayments.

Total cost-sharing amounts are difficult to monitor.

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Who presented this material?

Judith Arnold and Leighton Ku, Ph.D., M.P.H.

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