Impacts of Performance Pay for Hospitals: The Readmissions Reduction Program

• 成果类型: Article
• 署名作者: Gupta, Atul
• 署名单位: University of Pennsylvania; University of Pennsylvania
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20171825
• 发表日期: 2021
• 页码: 1241-1283
• 关键词: instrumental-variable estimation; acute myocardial-infarction; quality-of-care; health-care; incentive contracts; for-performance; association; physicians; mortality; rates

摘要

US policy increasingly ties payments for providers to performance on quality measures, though little empirical evidence guides the design of such incentives. I deploy administrative data to study a large federal program that penalizes hospitals with high readmissions rates. Using policy-driven variation in the penalty incentive across hospitals for identification, I find that hospital responses to the penalty account for two-thirds of the observed decrease in readmissions over this period, as well as a decrease in heart attack mortality. Quality improvement accounts for about one-half of the decrease in readmissions; the remainder is explained by selective admission of returning patients.