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Hospital Cost and Efficiency Under Per Service and Per Case Payment in Maryland: A Tale of the Carrot and the Stick / David S. Salkever, Donald M. Steinwachs, Agnes Rupp.

NBER Working papers Available online

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Format:
Book
Author/Creator:
Salkever, David S.
Contributor:
National Bureau of Economic Research.
Steinwachs, Donald M.
Rupp, Agnes.
Series:
Working Paper Series (National Bureau of Economic Research) no. w1633.
NBER working paper series no. w1633
Language:
English
Physical Description:
1 online resource: illustrations (black and white);
Other Title:
Hospital Cost and Efficiency Under Per Service and Per Case Payment in Maryland
Place of Publication:
Cambridge, Mass. National Bureau of Economic Research 1985.
Summary:
The simultaneous operation of per case and per servicepayment systems in Maryland, and the varying levels of stringency used in setting per case rates allows comparison of effects of differing incentive structures on hospital costs. This paper presents such a comparison with 1977-1981 data. Cost per case and total cost regressions show evidence of lower costs only when per case payment limits are very stringent. Positive net revenue incentives appear insufficient to induce reductions in length of stay and in ancillary services use. Our results suggest these changes in medical practice patterns are more likely under the threat of financial losses.
Notes:
Print version record
June 1985.

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