Avoidance of health care services because of cost: impact of the medicare savings program
- PMID: 15647239
- PMCID: PMC1464118
- DOI: 10.1377/hlthaff.24.1.263
Avoidance of health care services because of cost: impact of the medicare savings program
Abstract
The Qualified Medicare Beneficiary (QMB) program, part of the Medicare Savings Program, provides Medicare premium and cost-sharing assistance to low-income beneficiaries but has low participation rates. We examined the potential for QMB coverage to reduce the avoidance of health care services because of cost among low-income seniors in eight states. Only one-third of eligible seniors participated. Adjusted for demographics and health status, QMB enrollees were half as likely as nonenrollees to avoid physician visits because of cost. Despite its potential to improve access to primary care, the QMB program is underused. Future policy and research efforts should address low participation rates.
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References
-
- M.E. Gluck, Medicare Chart Book (Menlo Park, Calif.: Henry J. Kaiser Family Foundation, Fall 2001).
-
- The 2003 federal poverty level was $8,980 for individuals and $12,120 for couples. For data on beneficiary spending, see Crystal S, et al. “Out-of-Pocket Health Care Costs among Older Americans,” Journals of Gerontology Series B: Psychological Sciences and Social Sciences 55S12000S51–62. - PubMed
- Gross DJ, et al. “Out-of-Pocket Health Spending by Poor and Near-Poor Elderly Medicare Beneficiaries,”. Health Services Research. 1999;34(1 Part 2):241–54. - PMC - PubMed
-
- Henry J. Kaiser Family Foundation, “Medicare Advantage Fact Sheet” (Menlo Park, Calif.: Kaiser Family Foundation, March 2004).
-
- K. Glaun, Medicaid Programs to Assist Low-Income Medicare Beneficiaries: Medicare Savings Programs Case Study Findings (Menlo Park, Calif.: Kaiser Commission on Medicaid and the Uninsured, May 2003).
-
- Ibid.;
- Lamphere JA, Rosenbach ML. “Promises Unfulfilled: Implementation of Expanded Coverage for the Elderly Poor,”. Health Services Research. 2000;35(1 Part 2):207–217. - PMC - PubMed
- S.T. Parente, W.N. Evans, and E.J. Bayer, The Impact of QMB Enrollment on Medicare Costs and Service Utilization (Bethesda, Md.: Project HOPE Center for Health Affairs, July 1995); and P.J. Neumann et al., Identifying Barriers to Elderly Participation in the Qualified Medicare Beneficiary Program, Report to the Health Care Financing Administration (Bethesda, Md.: Project HOPE CHA, August 1994).
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