Cost Sharing in the Emergency Department — Is It Safe? is It Needed?

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Abstract
The use of cost-sharing strategies such as copayments, deductibles, and coinsurance by health insurance plans is controversial. In shifting a portion of health care expenses from the insurance purchaser or provider to the patient, cost sharing invariably reduces the demand for services.18 Proponents suggest that attention to costs leads patients to reduce inappropriate use of services selectively, without curtailing needed care. However, distinguishing appropriate from inappropriate visits on the basis of symptoms is not always straightforward, even for health professionals.9 Unless cost sharing can be directed solely at inappropriate care, there is concern that some patients will delay seeking . . .