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Copayments and Emergency Department Use Among Adult Medicaid Enrollees

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  • Lindsay M. Sabik
  • Sabina Ohri Gandhi

Abstract

A number of state Medicaid programs have recently proposed or implemented new or increased copayments for nonemergent emergency department (ED) visits. Evidence suggests that copayments generally reduce the level of healthcare utilization, although there is little specific evidence regarding the effectiveness of copayments in reducing nonurgent ED use among Medicaid enrollees or other low‐income populations. Encouraging efficient and appropriate use of healthcare services will be of particular importance for Medicaid programs as they expand under the Patient Protection and Affordable Care Act. This analysis uses national data from 2001 to 2009 to examine the effect of copayments on nonurgent ED utilization among nonelderly adult enrollees. We find that visits among Medicaid enrollees in state‐years where a copayment is in place are significantly less likely to be for nonurgent reasons. Our findings suggest that copayments may be an effective tool for reducing use of the ED for nonurgent care. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Lindsay M. Sabik & Sabina Ohri Gandhi, 2016. "Copayments and Emergency Department Use Among Adult Medicaid Enrollees," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 529-542, May.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:5:p:529-542
    DOI: 10.1002/hec.3164
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    References listed on IDEAS

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    1. Dague, Laura, 2014. "The effect of Medicaid premiums on enrollment: A regression discontinuity approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 1-12.
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    Cited by:

    1. Berger, Michael & Six, Eva & Czypionka, Thomas, 2024. "Policy implications of heterogeneous demand reactions to changes in cost-sharing: patient-level evidence from Austria," LSE Research Online Documents on Economics 121162, London School of Economics and Political Science, LSE Library.
    2. Jakobsson, Niklas & Svensson, Mikael, 2016. "Copayments and physicians visits: A panel data study of Swedish regions 2003–2012," Health Policy, Elsevier, vol. 120(9), pages 1095-1099.
    3. Chen, Wen-Yi, 2020. "The welfare effect of co-payment adjustments on emergency department visits in medical centers: Evidence from Taiwan," Health Policy, Elsevier, vol. 124(11), pages 1192-1199.
    4. Ziad R. Ghandour, 2019. "Public-Private Competition in Regulated Markets," NIPE Working Papers 02/2019, NIPE - Universidade do Minho.
    5. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    6. Cathy J. Bradley & David Neumark & Lauryn Saxe Walker, 2017. "The Effect of Primary Care Visits on Health Care Utilization: Findings from a Randomized Controlled Trial," NBER Working Papers 24100, National Bureau of Economic Research, Inc.
    7. Berger, Michael & Six, Eva & Czypionka, Thomas, 2024. "Policy implications of heterogeneous demand reactions to changes in cost-sharing: Patient-level evidence from Austria," Social Science & Medicine, Elsevier, vol. 340(C).
    8. Simona Gamba & Niklas Jakobsson & Mikael Svensson, 2022. "The impact of cost-sharing on prescription drug demand: evidence from a double-difference regression kink design," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1591-1599, December.
    9. Bradley, Cathy J. & Neumark, David & Walker, Lauryn Saxe, 2018. "The effect of primary care visits on other health care utilization: A randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia," Journal of Health Economics, Elsevier, vol. 62(C), pages 121-133.
    10. Wang, Tianyu & Wen, Ke & Gao, Qiuming & Sun, Ruochen, 2023. "Small money, big change: The distributional impact of differentiated doctor's visit fee on healthcare utilization," Social Science & Medicine, Elsevier, vol. 339(C).

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