Internists say cost sharing, particularly deductibles, may cause patients to forgo or delay care

July 13, 2016

The American College of Physicians (ACP) today said that cost sharing, particularly deductibles, may cause patients to forgo or delay care, including medically necessary services. "The effects are particularly pronounced among those with low incomes and the very sick," said Nitin S. Damle, MD, MS, FACP, president of ACP.

"Addressing the Increasing Burden of Health Insurance Cost Sharing," ACP's most recent position paper, was released today by the 148,000-member organization.

"Underinsurance is emerging as a serious problem that may be more difficult to tackle than un-insurance," Dr. Damle said. "Evidence shows that when cost sharing is imposed, consumers may respond by reducing their use of both necessary and unnecessary care."

ACP's asserts that a different cost-sharing approach is needed to ensure that vulnerable people can afford medically necessary care in the face of rising health coverage costs and stagnant wages.

The five recommendations in the paper address ways cost sharing can be made more equitable in the private market by reducing overall health care spending, designing insurance plans that allow access to high-value services, enhancing financial subsidies for marketplace-based insurance plans, improving outreach and health insurance literacy and education, and advocating for updated research on the effects of patient cost sharing. They are: "An alternative approach is needed to reduce spending through systemic reform of the health-care sector, protect low-income workers from overly burdensome out-of-pocket costs, enhance subsidies for marketplace Quality Health Programs, increase health care literacy, and direct shoppers to the right type of plan so that patients are shielded from financial ruin and insurance can function as intended," Dr. Damle concluded. "ACP has provided that today with this position paper."
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The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 148,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

American College of Physicians

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