Medicare's disproportionate share adjustment and the cost of low-income patients

We investigated whether or not hospitals have higher costs for inpatient care provided to low-income Medicare patients, after controlling for other cost differences already accounted for by Medicare payments. We estimated differences in Prospective Payment System-adjusted costs and outlier-adjusted...

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Bibliographic Details
Published in:Journal of health economics 1997-04, Vol.16 (2), p.177-190
Main Authors: Kominski, Gerald F., Long, Stephen H.
Format: Article
Language:English
Subjects:
Cost of Illness
Costs
Disproportionate share adjustment
Health administration
Health care expenditures
Health economics
Health insurance
Health Services Research
Hospital costs
Hospital Costs - statistics & numerical data
Hospital payment
Hospitalization - economics
Hospitalization - statistics & numerical data
Hospitals
Indigent care
Length of Stay - statistics & numerical data
Low income
Low income groups
Low-income patients
Medicare
Medicare Part A - economics
Medicare Part A - utilization
Patient Discharge
Patients
Poverty - statistics & numerical data
Prospective payment system
Prospective Payment System - economics
Prospective Payment System - statistics & numerical data
Prospective payment systems
Regression Analysis
Reimbursement
Statistical analysis
Studies
U.S.A
United States
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Summary:We investigated whether or not hospitals have higher costs for inpatient care provided to low-income Medicare patients, after controlling for other cost differences already accounted for by Medicare payments. We estimated differences in Prospective Payment System-adjusted costs and outlier-adjusted length of stay for low-income patients relative to matching non-low-income cases from the same hospital in 85 high-volume diagnosis-related groups ( N = 1,247,670). Low-income Medicare patients do not have costlier hospital stays, although their stays are 2.5% longer. We conclude that disproportionate share payments are not justified on grounds of higher treatment costs.
ISSN:0167-6296
1879-1646
DOI:10.1016/S0167-6296(96)00519-X