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首页> 外文期刊>Journal of health economics >Hospital volume responses to Medicare's Outpatient Prospective Payment System: Evidence from Florida
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Hospital volume responses to Medicare's Outpatient Prospective Payment System: Evidence from Florida

机译：医院对Medicare门诊预付款系统的反应：来自佛罗里达的证据

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摘要

Effective in 2000, Medicare's Outpatient Prospective Payment System (OPPS) sets pre-determined reimbursement rates for hospital outpatient services, replacing the prior cost-based methods of reimbursement. Using Florida outpatient discharge data, we study the effect of OPPS on hospital outpatient volume. We find that on average Medicare rate cuts either decreased or had no significant effect on Medicare volume, but increased private fee-for-service (FFS) volume. We also find that responses vary with the hospital's "exposure" to Medicare payment changes, where exposure is measured as the baseline Medicare patient share. Compared to less exposed hospitals, highly exposed hospitals responded with larger increases in private FFS volume and with smaller decreases (in some cases, even increases) in Medicare volume when payment rates fell. Our results are consistent with provider demand inducement.
机译：从2000年开始生效，Medicare的门诊预付款系统（OPPS）设定了医院门诊服务的预定报销率，从而取代了以前的基于成本的报销方法。使用佛罗里达州的门诊出院数据，我们研究了OPPS对医院门诊量的影响。我们发现，平均Medicare降息幅度对Medicare量有所减少或没有显着影响，但私人服务收费（FFS）量却有所增加。我们还发现，随着医院对Medicare付款变化的“暴露”而做出的反应也有所不同，其中，暴露水平以Medicare患者的基准​​基线为基准。与暴露程度较低的医院相比，暴露程度较高的医院在支付率下降时，私人FFS数量增加较大，而Medicare数量减少幅度较小（在某些情况下甚至增加）。我们的结果与提供者需求的诱导一致。

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