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If you think copayments for home care are a bad idea, you have a new study on your side.

Increased copayments for doctor visits lead to a reduction in those visits for Medicare beneficiaries, according to a new study published in the latest New England Journal of Medicine. Then in the next year, hospital costs increased for those patients who had seen the doctor less.

"Raising cost sharing for ambulatory care among elderly patients may have adverse health consequences and may increase total spending on health care," the study authors conclude in the abstract.

The same principle can be applied to home care visits, industry observers point out. Especially when "the effects of increases in copayments for ambulatory care were magnified among enrollees living in areas of lower income and education and among enrollees who had hypertension, diabetes, or a history of myocardial infarction," as the study highlights.

Medicare managed care plans might be getting the message. Most Medicare Advantage plans -- 88 percent -- don't charge home health copays, says a new report from the Kaiser Family Foundation,"Medicare Advantage 2010 Data Spotlight: Benefits and Cost-Sharing."

Private fee for service (PFFS) plans charge copays most often among the different types of MA plans, the report says. Of plans that do charge copays, the copays average $16.64 per visit.

Since 2008, the percentage of MA plans charging home health copays has gone down and copay levels have remained stable, KFF found.

Also, MA plan Medicare beneficiaries who are using home care have an average of 37 visits per year, the report says.

Resources: More information on the NEJM study is at . More information on the KFF study is at