Kansas Blue Cross/Blue Shield Outpatient Benefits Experiment

Abstract

A widely held, but unproven assumption holds that health insurance which financed more comprehensive services for ambulatory patients would significantly lower the rate of hospital admissions. This study reports on an attempt to test this assumption through a statistically controlled experiment. The Kansas Blue Cross/Blue Shield Plan provided free out-of-hospital benefits to an experimental group of 5,000 contracts for eight months during 1968. This group's inpatient claims experience was tested for significant changes by comparisons with prior experience and with a control group of 10,000 contracts. While the experimental benefits did not significantly alter the experimental group's total inpatient utilization rates, further analysis suggests that the benefits might have affected the distribution of inpatient care.