Herzberg says Kaiser's physicians have strong feelings about copayment amounts. If you have a high copay for a prenatal visit, the member is probably going to skip visits to save money. You don't want to make it so frivolous that someone takes Susie or Johnny to the ER at will because it doesn't cost much. No worry there. But other disciplines can be more sensitive to variable copayments.
Research bears out the success of the intent.
A 1995 Rand Corp. study found as much as a 35-percent decrease in outpatient mental health visits when copayments were introduced. Another Rand study this year suggested that chiropractic utilization is nearly as vulnerable to cost-sharing as outpatient mental health. When patients cannot afford a high copayment, some practitioners can be left in an ethical or legal bind. Providers that waive copayments may violate their managed care contracts. And those that do it for Medicare or Medicaid clients risk the wrath of the Health Care Financing Administration, which strictly forbids routine waivers.