The effects of Medicare payment subsidies to teaching hospitals.

BBA Impacts on Hospital Residents, Finances, and Medicare Subsidies

Concern over rapidly rising Medicare expenditures prompted Congress to pass the 1997 Balanced Budget Act (BBA) that included provisions reducing graduate medical education (GME) payments and capped the growth in residents for payment purposes. Using Medicare cost reports through 2001, we find that both actual and capped residents continued to grow post-BBA. While teaching hospital total margins...

The Balanced Budget Act of 1997 and the financial health of teaching hospitals.

BACKGROUND We wanted to evaluate the most recent, complete data related to the specific effects of the Balanced Budget Act of 1997 relative to the overall financial health of teaching hospitals. We also define cost report variables and calculations necessary for continued impact monitoring. METHODS We undertook a descriptive analysis of hospital cost report variables for 1996, 1998, and 1999,...

4C ASSGEIATION OF AMERICAN MEDICAL COLLEGES Medicare Payment Issues of Interest to Teaching Hospitals

Medicare prospective payment without separate urban and rural rates

The elimination of urban-rural differences in the Medicare prospective payment system (PPS) standard rates implies a need to re-examine all the PPS payment adjustments. Refinements for case mix, outliers, and the wage index can make a significant contribution to avoiding payment disparities in a single-rate system. However, changes in the adjustments for teaching and disproportionate-share (DSH...

Informal Payment in Health Settings: A Survey of Teaching Hospitals

Background and Objectives: Informal payment in the health settings is a significant challenge facing the health system, with consequences such as inequity in access to healthcare services, distrust to health care system, and dissatisfied customers. Detailed identification of the nature of the problem is perquisite to developing relevant overcoming strategies. Given that, this study aimed at pro...