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Recently, many health plans have increased co-payments for outpatient visits. Although the rationale presumably is to minimize unnecessary ambulatory care, the strategy could backfire if higher co-payments dissuade patients from obtaining necessary clinical services.
To examine this issue, researchers analyzed data from 36 Medicare managed care plans with nearly one million enrollees. In 18 plans, mean co-payments for outpatient visits increased during the study period (2001–2006), from a mean of US$7 to $14 for primary care visits and from $13 to $22 for specialist visits. In 18 “control” plans, co-payments stayed the same during the study interval.
During the year after outpatient co-payments increased, 20 fewer outpatient visits occurred p…