| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w22709 |
| 来源ID | Working Paper 22709 |
| Why Don\u2019t Commercial Health Plans Use Prospective Payment? | |
| Laurence Baker; M. Kate Bundorf; Aileen Devlin; Daniel P. Kessler | |
| 发表日期 | 2016-10-10 |
| 出版年 | 2016 |
| 语种 | 英语 |
| 摘要 | One of the key terms in contracts between hospitals and insurers is how the parties apportion the financial risk of treating unexpectedly costly patients. “Prospective” payment contracts give hospitals a lump-sum amount, depending on the medical condition of the patient, with limited adjustment for the level of services provided. We use data from the Medicare Prospective Payment System and commercial insurance plans covering the nonelderly through the Health Care Cost Institute to measure the extent of prospective payment in 303 metropolitan statistical areas during 2008-12. We report three key findings. First, commercial insurance payments are less prospective than Medicare payments. Second, the extent of prospective payment in commercial insurance varies more than in Medicare, both across hospitals and geographic areas. Third, differences in prospective payment across hospitals are positively associated with the extent of hospital competition, the share of the hospital’s commercially insured patients covered by managed-care insurance, and the share of the hospital’s patients covered by Medicare’s Prospective Payment System. |
| 主题 | Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w22709 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/580383 |
| 推荐引用方式 GB/T 7714 | Laurence Baker,M. Kate Bundorf,Aileen Devlin,et al. Why Don\u2019t Commercial Health Plans Use Prospective Payment?. 2016. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w22709.pdf（108KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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