Does Competition Under Medicare Prospective Payment Selectively Reduce Expenditures on High-Cost Patients?  

Oleh:

Chung, Jeanette ; Meltzer, David ; Basu, Anirban

Jenis: Article from Bulletin/Magazine
Dalam koleksi: The Rand Journal of Economics vol. 33 no. 3 (2002), page 447-468.
Topik: EXPENDITURES; competition; medicare prospective; payment; reduce expenditures; high - cost patients

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: RR10.7 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Competition and prospective payment have been widely used to control health care costs but may together provide incentives to selectively reduce expenditures on high - cost relative to low - cost users. We use patient discharge and hospital financial data from California to examine the effects of competition on costs for high - and low - cost admissions in the 12 largest Diagnosis - Related Groups before and after the Medicare Prospective Payment System (PPS). We find that competition increased costs before PPS, but that this effect decreased afterward, especially in patients with the highest costs. We conclude that competition and PPS selectively reduced spending among the most expensive patients and that careful assessment of these patients' outcomes is important.

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