Association of Reference Payment for Colonoscopy With Consumer Choices, Insurer Spending, and Procedural Complications.

ABSTRACT:

Importance

Regulatory limits on consumer cost sharing permit wide variation in the prices charged for screening and diagnostic tests such as colonoscopy. Employers are experimenting with reference payment initiatives that offer full insurance coverage at low-priced facilities but require substantial cost sharing if patients select high-priced alternatives.

Objective

To ascertain the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy.

Design, setting, and participants

The California Public Employees' Retirement System (CalPERS) implemented reference payment in January 2012. We obtained data on 21 644 CalPERS enrollees who underwent colonoscopy in the 3 years prior to implementation and o

SUBMITTER: Robinson JC 

PROVIDER: S-EPMC10799681 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature