Regulated Revenues and Hospital Behavior: Evidence from a Medicare Overhaul

• 成果类型: Article
• 署名作者: Gross, Tal; Sacarny, Adam; Shi, Maggie; Silver, David
• 署名单位: Boston University; National Bureau of Economic Research; Columbia University; University of Chicago; University of California System; University of California Santa Barbara
• 刊物名称: REVIEW OF ECONOMICS AND STATISTICS
• ISSN/ISSBN: 0034-6535
• DOI: 10.1162/rest_a_01254
• 发表日期: 2024-11
• 页码: 1709-1718
• 关键词: health-care; eligibility; cost

摘要

We study a 2008 policy reform in which Medicare revised its hospital payment system to better reflect patients' severity of illness. We construct a simulated instrument that predicts a hospital's policy-induced change in reimbursement using pre-reform patients and postreform rules. The reform led to large persistent changes in Medicare payment rates across hospitals. Hospitals that faced larger gains in Medicare reimbursement increased the volume of Medicare patients they treated. The estimates imply a volume elasticity of 1.2. To accommodate greater volume, hospitals increased nurse employment, but also lowered length of stay.