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 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 Physician Responses to Medicare Reimbursement Rates written by Aileen Devlin and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: I investigate how office-based physicians respond to Medicare reimbursement changes. Using variation from an Affordable Care Act policy that increased reimbursements in four states, I run a difference-in-difference analysis comparing physicians with higher reimbursement increases to those with lower increases. I find two mechanisms through which physicians respond. First, physicians with higher reimbursement increases were more likely to continue providing office-based care than physicians with lower increases. This was offset by decreased movement to hospital-based care, which I interpret as decreased vertical integration. Second, I find that physicians who remain office-based exhibit a positive intensive margin supply response.
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.
Download or read book Improving the Quality of Long Term Care written by Institute of Medicine and published by National Academies Press. This book was released on 2001-02-27 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
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 Hospital Response to Changes in Medicaid Reimbursement written by Preethi M. Rao and published by . This book was released on 2016 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: Changes to reimbursement levels and reimbursement methodology have become increasingly common as public health insurance programs seek to slow the rate of cost growth. Despite the fact that Medicaid is a major public health insurance program, little is known about how hospitals respond to price cuts by Medicaid. On the other hand, existing research on hospital response to a commonly used payment method (prospective payment) by Medicaid is largely based on policy changes from the 1980s. In this dissertation, I study 1) how hospitals in California responded to a 10% payment reduction by Medicaid in 2008, and 2) how hospitals in California responded to the 2013 introduction of a prospective payment system by Medicaid. For both analyses, I make use of hospital and emergency department discharge records from the California Office of Statewide Health Planning and Development, and study outcomes related to access to hospital care and intensity of care. I find little response to the 10% payment cut along these margins; suggesting that hospitals may have responded along other margins. In the analysis of hospital response to prospective payment, I find results consistent with theoretical predictions as well as the existing literature. Hospitals responded to prospective payment by reducing average inpatient length of stay. Furthermore, this response was driven primarily by hospitals with the strongest incentives--those previously paid on a per diem basis. These results suggest that hospitals may not respond strongly to across-the-board payment cuts in the way that they treat patients. On the other hand, hospitals had a strong, immediate, and predictable response to a change in the payment methodology, suggesting that perhaps this is a more effective policy tool.
Download or read book Hospital Volume Responses to Medicare s Outpatient Prospective Payment System written by Daifeng He and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Effective in 2000, Medicare's Outpatient Prospective Payment System (OPPS) sets pre-determined reimbursement rates for hospital outpatient services, replacing the prior costbased methods of reimbursement. Using Florida outpatient discharge data, we study the effect of OPPS on hospital outpatient volume. We find that on average Medicare rate cuts either decreased or had no significant effect on Medicare volume, but increased private fee-for-service (FFS) volume. We also find that responses vary with the hospital's “exposure” to Medicare payment changes, where exposure is measured as the baseline Medicare patient share. Compared to less exposed hospitals, highly exposed hospitals responded with larger increases in private FFS volume and with smaller decreases (in some cases, even increases) in Medicare volume when payment rates fell. Our results are consistent with provider demand inducement.
Download or read book Issues Relating to Medicare Hospital Payments written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1985 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Use of Unaudited Hospital Cost Data Resulted in Overstatement of Medicare s Prospective Payment System Rates written by United States. General Accounting Office and published by . This book was released on 1985 with total page 24 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 Regulated Revenues and Hospital Behavior written by Tal Gross and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: We study a 2008 policy reform in which Medicare revised its hospital payment system to better reflect patients' severity of illness. We construct a simulated instrument that predicts a hospital's policy-induced change in reimbursement using pre-reform patients and post-reform rules. The reform led to large persistent changes in Medicare payment rates across hospitals. Hospitals that faced larger gains in Medicare reimbursement increased the volume of Medicare patients they treated. The estimates imply a volume elasticity of approximately unity. To accommodate greater volume, hospitals increased nurse employment, but also lowered length of stay, with ambiguous effects on quality.
Download or read book The Medicare Handbook written by and published by . This book was released on 1989 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Government Cutbacks in Hospital Reimbursement written by David Dranove and published by . This book was released on 1995 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Hospital Response to Medicare Reimbursement Incentives written by Stuart A. Hagen and published by . This book was released on 1998 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Tentoonstelling van teekeningen op de schrijfmachine vervaardigd ten bate van plaatselijke crisis comit s written by and published by . This book was released on 1932 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Hospital Responses to Reimbursement Changes written by Urban Health Institute (East Orange, N.J.) and published by . This book was released on 1978 with total page 700 pages. Available in PDF, EPUB and Kindle. Book excerpt:
