PMID: 10107845Oct 6, 1990Paper

Using hospital-specific costs to improve the fairness of prospective reimbursement

Journal of Health Economics
G C Pope

Abstract

Payment rates in Medicare's Prospective Payment System (PPS) are based on averages of historical hospital costs. Compared to reimbursing each hospital's own costs, pricing at the average of costs implies a massive redistribution of payments among hospitals. Because not all sources of hospital costs are accounted for in the PPS, some of this redistribution is 'unfair'. Information in hospital-specific costs on unmeasured patient severity and input prices can be exploited to reduce payment inequities. However, fully hospital-specific rates are not optimal because costs also reflect treatment intensity and efficiency differences among hospitals.

References

Oct 1, 1987·The New England Journal of Medicine·J FederS Zuckerman
Jul 10, 1983·Journal of Health Economics·P L Joskow
Feb 9, 1987·Journal of Health Economics·R C Van Vliet, B M Van Praag
May 10, 1986·Journal of Health Economics·R P Ellis, T G McGuire
May 9, 1989·Journal of Health Economics·A M Hendricks
May 9, 1989·Journal of Health Economics·G C Pope
Aug 7, 1988·Journal of Health Economics·R P Ellis, T G McGuire

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Citations

Jan 1, 1996·Journal of Mental Health Administration·E M FosterR C Saunders
May 26, 2010·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·David CrainichAna Mauleon
Jun 24, 2008·International Journal of Health Care Finance and Economics·David CrainichAna Mauleon
Oct 6, 1990·Journal of Health Economics·E B Keeler
Sep 5, 1994·Journal of Health Economics·J P Newhouse
Mar 4, 1994·The Journal of Economic Perspectives : a Journal of the American Economic Association·R P Ellis, T G McGuire
May 23, 2015·Health Policy·Jason M Sutherland
Oct 26, 2018·Cost Effectiveness and Resource Allocation : C/E·Abdelbaste HrifachCyrille Colin
Feb 11, 2005·Applied Health Economics and Health Policy·Karen Eggleston, Chee-Ruey Hsieh

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