Payment levels and hospital response to prospective payment.

Hospital Response to Changes in Medicaid Reimbursement

Changes to reimbursement levels and reimbursement methodology have become increasingly common as public health insurance programs seek to slow the rate of cost growth. Despite the fact that Medicaid is a major public health insurance program, little is known about how hospitals respond to price cuts by Medicaid. On the other hand, existing research on hospital response to a commonly used paymen...

Unintended Consequences of Hospital Payment: The Case of Swiss Diagnosis Related Groups

Background: In 2012, Switzerland changed from retrospective to prospective hospital payment based on diagnosis related groups (DRGs), following the example of the United States, Australia, and Germany. As in these countries, the objective of this transition was to motivate hospitals to improve efficiency by making them bear financial risk to some extent.Objective:...

The lessons of Medicare's prospective payment system show that the bundled payment program faces challenges.

Policy makers have been trying to replace Medicare's fee-for-service payment system for years with approaches that pay one price for an aggregation of services. The intent is to reward providers for offering needed care in the most appropriate and cost-effective manner. Medicare's first payment change designed to accomplish such a change was the hospital prospective payment system, introduced d...

Prospective payment for inpatient psychiatric care

The 2009 Hospital Financing Reform Act (KHRG) mandated the German self-governing bodies to develop a prospective payment system (PPS) for psychiatric and psychosomatic facilities. The process of developing the system mirrors the introduction of DRGs for other hospitals prior 2004. However, the future psychiatric PPS will be based on per diem payments adjusted for patient characteristics and pro...

In Defense of Regulated Fee-for-Service Payment: A Response to Recent Commentaries