Download or read book Changes in Hospital Service Mix and Cost Allocations in Response to Changes in Medicare Reimbursement Schemes written by Leslie Eldenburg and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper tests whether cost allocations are manipulated in response to cost-plus reimbursement. After 1983, Medicare started reimbursing hospitals for inpatient services on the basis of rates set prospectively, but continued to reimburse outpatient services based on cost. Using data from Washington State, we find that hospitals responded by increasing outpatient services to Medicare patients -- the ratio of Medicare outpatient revenues as a percentage of total Medicare revenues increased after 1983 to a significantly greater extent than for non-Medicare patients. We also find that allocations of common costs to outpatient departments after 1983 significantly exceeded those to inpatient departments, compared to the allocation pattern prior to 1983. These results are robust to alternative controls and cost function specifications.

Download or read book Hospital Responses to Medicare Reimbursement Rate Changes written by Bryan J. Perry and published by . This book was released on 2018 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals face an environment of declining real per-patient reimbursement from Medicare. Understanding the provider response to changing Medicare prices is critical for balancing the complex incentives of hospitals and patients with the fiscal and social objectives of the public insurance program. In this paper I exploit the Medicare rural floor, a discontinuity in geographic adjustments to Medicare payments to hospitals, in a regression kink design to estimate the impact of Medicare reimbursement rate changes on the level and mix of hospital services provided. I find that hospitals respond to higher Medicare reimbursement by admitting more Medicare patients, but that the average duration of a patient stay declines. I also document a previously unstudied spillover of Medicare reimbursement on the volume of admitted patients with non-Medicare insurance. Contrary to the prediction of existing standard models, both Medicaid and private patient utilization significantly increase in response to Medicare rate hikes. Higher Medicare prices coupled with higher utilization across all patient categories leads to a large increase in hospital revenue. Hospitals deploy the revenue, almost exclusively, in expenses for patient care.

Download or read book Medicare and the American Health Care System written by and published by . This book was released on 1991 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Effect of Changes in Capital Asset Ownership on Medicare Costs written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1984 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Need to More Consistently Reimburse Health Facilities Under Medicare and Medicaid Department of Health Education and Welfare written by United States. General Accounting Office and published by . This book was released on 1974 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicare Prospective Payment and the American Health Care System written by and published by . This book was released on 1986 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Contributions of Case Mix Intensity and Technology to Hospital Cost Increases Under Medicare s Prospective Payment System written by Gerald F. Kominski and published by RAND Corporation. This book was released on 1993 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study examined why the average cost of Medicare hospital discharges increased more rapidly than inflation after the implementation of Medicare's prospective payment system (PPS). The average cost per Medicare case rose by 28.4 percent between 1984 and 1987. The increase in the hospital market basket was 11.0 percent during this period, thus, the real increase in cost per case was 15.7 percent. The authors decomposed this change in real cost per case into two major components: changes across DRGs (i.e. case mix) and changes within DRGs (i.e. intensity). Average cost per case increased 11.2 percent due to changes in case mix, and 4.5 percent due to higher costs per case within DRGs. We further decomposed the across- and within-DRG increases into the following components: technology, outpatient shift, and a residual. The authors estimate that technology changes accounted for 5.8 percent of the total increase in cost per case, while outpatient shift accounted for 3.4 percent of the total increase.

Download or read book Impact of the Medicare Hospital Prospective Payment System written by and published by . This book was released on 1984 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Geographic Adjustment in Medicare Payment written by Institute of Medicine and published by National Academies Press. This book was released on 2012-10-31 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.

Download or read book Adjustments to the Medicare Prospective Payment System written by United States. Prospective Payment Assessment Commission and published by . This book was released on 1990 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicare and Medicaid Programs Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals Et Al Us Centers for Medicare and Medicaid Services Regulation Cms 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-05 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare and Medicaid Programs - Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, et al. (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare and Medicaid Programs - Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, et al. (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. This book contains: - The complete text of the Medicare and Medicaid Programs - Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, et al. (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Download or read book Changes in Medicare Reimbursement Policies written by Lisa L. Dorsey and published by . This book was released on 2002 with total page 534 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Information on Use of Medicare Reimbursement Method to Determine Hospital Payments Under the Civilian Health and Medical Program of the Uniformed Services written by United States. General Accounting Office and published by . This book was released on 1977 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Improving Medicare s Policy for Payment of Unusual Hospital Cases written by Grace M. Carter and published by . This book was released on 1992 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: In FY 1989, the Health Care Financing Agency (HCFA) changed the amount it would pay for extremely long or costly Medicare hospital stays called outliers. Based on a 20% sample of Medicare hospitalizations as recorded in the Medicare Provider Analysis and Review (MEDPAR) file, the authors compared the distribution of outlier payments under the FY 1989 policy with the FY 1988 distribution under the previous policy; described the extent to which each policy provided reimbursement to the most costly cases and examined the distribution of outlier payments among other patient groups and among hospital groups; and estimated the effect of outlier payments on hospitals' financial risk using the methodology developed in Keeler et al. (1988). The authors examined three characteristics of stays that hospitals might have changed in response to the incentives inherent in outlier policy: (1) the resources provided to long-staying patients, (2) the discharge rate near the old outlier threshold, and (3) the concentration of very expensive cases in public hospitals in large urban areas. The outlier policy appears to have accomplished several goals. In particular, the new policy succeeded in: concentrating outlier funds on the costliest cases; providing more funds to hospitals with cases that are more costly than average for their Diagnosis Related Group (DRG); and decreasing risk by 5% from what it would have been if the policy had not changed. The study also identified two problems with existing outlier policy: (1) day outlier payments frequently exceed the cost of the services delivered; and (2) the formula for setting cost outlier thresholds produces less than optimum protection from risk. Although the changes were not large, the authors found some evidence that hospitals responded to the outlier policy change both by increasing length of stay and increasing the services delivered to the most costly patients. They judge that this analysis increases the strength of the argument for using case-based rather than hospital-based outlier payments.

Download or read book Recommendations Regarding Medicare Hospital and Physician Payment Policies written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1999 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Health Economics and Healthcare Reform Breakthroughs in Research and Practice written by Management Association, Information Resources and published by IGI Global. This book was released on 2017-07-12 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: The effective delivery of healthcare services is vital to the general welfare and well-being of a country’s citizens. Financial infrastructure and policy reform can play a significant role in optimizing existing healthcare programs. Health Economics and Healthcare Reform: Breakthroughs in Research and Practice is a comprehensive source of academic material on the importance of economic structures and policy reform initiatives in modern healthcare systems. Highlighting a range of pertinent topics such as clinical costing, patient engagement, and e-health, this book is ideally designed for medical practitioners, researchers, professionals, and students interested in the optimization of healthcare delivery.

Download or read book Medicare Reimbursement and the Quality of Hospital Care written by Michael J. McGinty and published by DIANE Publishing. This book was released on 1993 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: Examines the relationship between hospital reimbursement per discharge & the clinical quality of care received by Medicare patients before & after the implementation of the PPS in 1993-1984. Objectives were to evaluate the link between program, payments & quality & to identify characteristics of higher & lower quality hospitals for the period 1981 to 1986.