Some Interim Results from a Controlled Trial in Health Insurance

Published in: Evaluation Studies: Review Annual / ed. By Aiken L. H., Kehrer B. H. (Beverly Hills, CA: 1985), v. 10, p. 53-80

Posted on RAND.org on December 31, 1984

by Joseph P. Newhouse, Willard G. Manning, Carl N. Morris, Larry L. Orr, Robert H. Brook

Read More

Access further information on this document at content.nejm.org

This article was published outside of RAND. The full text of the article can be found at the link above.

A total of 7706 persons are participating in a controlled trial of alternative health-insurance policies. Interim results indicate that persons fully covered for medical services spend about 50 per cent more than do similar persons with income-related catastrophe insurance. Full coverage leads to more people using services and to more services per user. Both ambulatory services and hospital admissions increase. Once patients are admitted to the hospital, however, expenditures per admission do not differ significantly among the experimental insurance plans. In addition, hospital admissions for children do not vary by plan. The income-related cost sharing in the experimental plans affects expenditure by different income groups similarly, but adults' total expenditure varies more than children's. Sufficient data are not available on whether higher use by persons with free care reflects overuse, or whether lower use by those with income-related catastrophe coverage reflects underuse. Both may well be true.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.