A Randomized Experiment of the Split Benefit Health Insurance Reform to Reduce High-Cost, Low-Value Consumption

1 Innovation & Entrepreneurship in Health 5 (2014)

Arizona Legal Studies Discussion Paper No. 15-01

8 Pages Posted: 6 Jan 2015  

Christopher T. Robertson

University of Arizona - James E. Rogers College of Law; Harvard University - Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics

David V. Yokum

University of Arizona - James E. Rogers College of Law; University of Arizona - College of Science

Nimish Sheth

University of Southern California

Keith A. Joiner

University of Arizona - College of Medicine

Date Written: January 4, 2015

Abstract

Traditional cost sharing for health care is stymied by limited patient wealth. The “split benefit” is a new way to reduce consumption of high-cost, low-value treatments for which the risk/benefit ratio is uncertain. When a physician prescribes a costly unproven procedure, the insurer could pay a portion of the benefit directly to the patient, creating a decision opportunity for the patient. The insurer saves the remainder, unless the patient consumes. In this paper, a vignette-based randomized controlled experiment with 1,800 respondents sought to test the potential efficacy of the split benefit. The intervention reduced the odds of consumption by about half. It did so regardless of scenario (cancer or cardiac stent), type of split (rebate, prepay, or health savings account), or amount of split (US$5,000 or US$15,000). Respondents viewed the insurer that paid a split as behaving fairly, as it preserved access and choice. Three-quarters of respondents supported such use in Medicare, which did not depend on political party affiliation. The reform is promising for further testing since it has the potential to decrease spending on low-value interventions, and thereby increase the value of the health care dollar.

Keywords: insurance, payment, reform, incentive, benefit

Suggested Citation

Robertson, Christopher T. and Yokum, David V. and Sheth, Nimish and Joiner, Keith A., A Randomized Experiment of the Split Benefit Health Insurance Reform to Reduce High-Cost, Low-Value Consumption (January 4, 2015). 1 Innovation & Entrepreneurship in Health 5 (2014); Arizona Legal Studies Discussion Paper No. 15-01. Available at SSRN: https://ssrn.com/abstract=2545503

Christopher T. Robertson (Contact Author)

University of Arizona - James E. Rogers College of Law ( email )

P.O. Box 210176
Tucson, AZ 85721-0176
United States

HOME PAGE: http://www.law.arizona.edu/faculty/getprofile.cfm?facultyid=714

Harvard University - Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics ( email )

23 Everett Street
Cambridge, MA 02155
United States

David V. Yokum

University of Arizona - College of Science ( email )

1040 E. Fourth Street
Tucson, AZ 85721-0077
United States

University of Arizona - James E. Rogers College of Law ( email )

P.O. Box 210176
Tucson, AZ 85721-0176
United States

Nimish Sheth

University of Southern California ( email )

Los Angeles, CA 90089
United States

Keith A. Joiner

University of Arizona - College of Medicine ( email )

Tucson, AZ 85721
United States

Paper statistics

Downloads
157
Rank
155,193
Abstract Views
1,395