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Invited Commentary
March 2015

Cost Sharing as a Tool to Drive Higher-Value Care

Author Affiliations
  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston Massachusetts
  • 2Institute for Social Research, University of Michigan, Ann Arbor
JAMA Intern Med. 2015;175(3):399-400. doi:10.1001/jamainternmed.2014.7595

Economists like to say that there is no free lunch, but reducing wasteful health care spending in public programs may be as close as we will ever get. The challenge is that reducing such spending, or even identifying it, is hard. Some of the policy options focus on the health care provider side (eg, payment reforms), while others focus on the patient side, including greater cost sharing.

The results reported by Siddiqui et al1 in this issue of JAMA Internal Medicine underscore the challenges in deploying these cost-sharing tools. They found that introducing copayments for nonurgent emergency department (ED) visits for Medicaid beneficiaries had no effect on utilization. What does this result mean for the use of patient cost sharing as a tool to drive the health care system toward greater value?

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