Document Detail


The impact of patient cost-sharing on low-income populations: Evidence from Massachusetts.
MedLine Citation:
PMID:  24287175     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Greater patient cost-sharing could help reduce the fiscal pressures associated with insurance expansion by reducing the scope for moral hazard. But it is possible that low-income recipients are unable to cut back on utilization wisely and that, as a result, higher cost-sharing will lead to worse health and higher downstream costs through increased use of inpatient and outpatient care. We use exogenous variation in the copayments faced by low-income enrollees in the Massachusetts Commonwealth Care program to study these effects. We estimate separate price elasticities of demand by type of service. Overall, we find price elasticities of about -0.16 for this low-income population - similar to elasticities calculated for higher-income populations in other settings. These elasticities are somewhat smaller for the chronically sick, especially for those with asthma, diabetes, and high cholesterol. These lower elasticities are attributable to lower responsiveness to prices across all categories of service, and to some statistically insignificant increases in inpatient care.
Authors:
Amitabh Chandra; Jonathan Gruber; Robin McKnight
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-1
Journal Detail:
Title:  Journal of health economics     Volume:  33C     ISSN:  1879-1646     ISO Abbreviation:  J Health Econ     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8410622     Medline TA:  J Health Econ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  57-66     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier B.V. All rights reserved.
Affiliation:
Harvard Kennedy School, Harvard University, United States; NBER, United States.
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