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BMC Health Services Research

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Open Access 01-12-2019 | Care | Research article

“Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”

Authors: Jennifer N. Goldstein, J. Sanford Schwartz, Patricia McGraw, LeRoi S. Hicks

Published in: BMC Health Services Research | Issue 1/2019

Abstract

Background

Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and health care rationing among low-income Medicare beneficiaries. The objective of this study was to explore the potential impact of observation cost-sharing on future medical decision making of Medicare beneficiaries.

Methods

Single-center pilot cohort study. A convenience sample of Medicare beneficiaries hospitalized under observation status care was surveyed.

Results

Out of 144 respondents, low-income beneficiaries were more likely to be concerned about the cost of their observation stay than higher-income respondents (70.7% vs29.3%, p = 0.015). If hospitalized under observation status again, there was a trend among low-income beneficiaries to request completion of their workup outside of the hospital (56.3% vs 43.8%), and to consider leaving against medical advice (AMA) (100% vs 0%), though these trends were not statistically significant (p = 0.30).

Conclusion

The results of this pilot study suggest that low-income Medicare beneficiaries hospitalized under observation status have greater concerns about their cost-sharing obligations than their higher income peers. Cost-sharing for observation care may have unintended consequences on utilization for low-income beneficiaries. Future studies should examine this potential relationship on a larger scale.

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Title: “Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”
Authors: Jennifer N. Goldstein
J. Sanford Schwartz
Patricia McGraw
LeRoi S. Hicks
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Care
Published in: BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-019-3982-8

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“Implications of cost-sharing for observation care among Medicare beneficiaries: a pilot survey”

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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