title: Cost sharing and its effects on hospital utilization. The Blue Cross and Blue Shield of North Carolina experience.
abstract: A natural movement away from traditional first-dollar health care benefits to coverage with cost-sharing features was studied among employer groups covered by Blue Cross and Blue Shield of North Carolina. The groups choosing the new benefits were atypical: they had a record of high rates of hospitalization. The new benefits were successful in shifting part of the financial burden away from the employer and, additionally, the groups collectively experienced a decline in inpatient utilization in excess of the decrease noted among controls. Despite the overall decline in utilization, their days/1000 remained in excess of the control groups in the year following the benefit change. Not every group experienced a utilization decline. Participants in counties with traditionally low levels of utilization did not experience a further decline.
mesh_terms: D054598:Blue Cross Blue Shield Insurance Plans; D003669:Deductibles and Coinsurance; D005260:Female; D006760:Hospitalization / Q000191:economics* / Q000639:trends; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007350:Insurance, Hospitalization; D007357:Insurance, Physician Services; D008297:Male; D009657:North Carolina