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. 1985 Fall;7(1):97-109.

Medicare expenditures and utilization under State hospital rate setting

J Cromwell, H Hewes

Medicare expenditures and utilization under State hospital rate setting

J Cromwell et al. Health Care Financ Rev. 1985 Fall.

Abstract

In this study we analyzed the National Hospital Rate-Setting Study findings concerning the effects of State prospective reimbursement (PR) programs on Medicare expenditures and utilization; we used Medicare beneficiary-based data complied from a sample of approximately 1,300 counties in States with and without rate-setting programs for the 5-year period 1974-78. The statistical evidence suggests that stringent PR programs have not resulted in hospitals using Medicare to cross-subsidize losses elsewhere. In addition, it appears that Medicare has been a passive recipient of the same kinds of regulatory benefits accruing to PR-covered patients (i.e., costs and intensity of care have been constrained).

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Figures

Figure 1
Figure 1. Prospective reimbursement regression coefficients: Medicare hospital, nonhospital and total reimbursements in percent, by State and year program started or changed
Figure 2
Figure 2. Prospective reimbursement regression coefficients: Medicare hospital and nonhospital utilization per beneficiary, by State and year program started or changed
See this image and copyright information in PMC

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