Study Results from University of California Broaden Understanding of Medical Research (Reference Pricing, Consumer Cost-Sharing, and Insurer Spending…

Health & Medicine Week

Study Results from University of California Broaden Understanding of Medical Research (Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests)

By a News Reporter-Staff News Editor at Health & Medicine Week -- Research findings on Health and Medicine - Medical Research are discussed in a new report. According to news reporting originating in Berkeley, California, by NewsRx journalists, research stated, "Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket."

The news reporters obtained a quote from the research from the University of California, "To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer."

According to the news reporters, the research concluded: "Implementation of reference pricing led to reductions in payments by both employer and employees."

For more information on this research see: Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests. Medical Care, 2016;55(12):1050-1055. Medical Care can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Medical Care - journals.lww.com/lww-medicalcare/pages/default.aspx)

Our news correspondents report that additional information may be obtained by contacting J.C. Robinson, University of California, Sch Public Hlth, Berkeley, CA 94720, United States. Additional authors for this research include C. Whaley and T.T. Brown (see also Health and Medicine - Medical Research).

Keywords for this news article include: Berkeley, California, United States, North and Central America, Medical Research, Health and Medicine, University of California.