Cargando…
Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems
The Medicare prospective payment system, which is based on the diagnosis-related group patient-classification system, identifies previously unrecognized redistributions of revenue among diagnosis-related groups and hospitals. The redistributions are caused by two artifacts. One artifact results from...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
CENTERS for MEDICARE & MEDICAID SERVICES
1984
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195108/ https://www.ncbi.nlm.nih.gov/pubmed/10311077 |
_version_ | 1782339257209192448 |
---|---|
author | Kominski, Gerald F. Williams, Sankey V. Mays, Randall B. Pickens, Gary T. |
author_facet | Kominski, Gerald F. Williams, Sankey V. Mays, Randall B. Pickens, Gary T. |
author_sort | Kominski, Gerald F. |
collection | PubMed |
description | The Medicare prospective payment system, which is based on the diagnosis-related group patient-classification system, identifies previously unrecognized redistributions of revenue among diagnosis-related groups and hospitals. The redistributions are caused by two artifacts. One artifact results from the use of labor market indexes to adjust costs for the different prices paid by hospitals in different labor markets. The other artifact results from the use of averages that are based on the number of hospitals, not the number of patients, to calculate payment rates from average costs. The effects of these artifacts in a sample data set have been measured, and it was concluded that they lead to discrepancies between costs and payments that may affect hospital incentives—the overall payment for each diagnosis-related group—and Medicare's total payment. |
format | Online Article Text |
id | pubmed-4195108 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 1984 |
publisher | CENTERS for MEDICARE & MEDICAID SERVICES |
record_format | MEDLINE/PubMed |
spelling | pubmed-41951082014-11-04 Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems Kominski, Gerald F. Williams, Sankey V. Mays, Randall B. Pickens, Gary T. Health Care Financ Rev Research Articles The Medicare prospective payment system, which is based on the diagnosis-related group patient-classification system, identifies previously unrecognized redistributions of revenue among diagnosis-related groups and hospitals. The redistributions are caused by two artifacts. One artifact results from the use of labor market indexes to adjust costs for the different prices paid by hospitals in different labor markets. The other artifact results from the use of averages that are based on the number of hospitals, not the number of patients, to calculate payment rates from average costs. The effects of these artifacts in a sample data set have been measured, and it was concluded that they lead to discrepancies between costs and payments that may affect hospital incentives—the overall payment for each diagnosis-related group—and Medicare's total payment. CENTERS for MEDICARE & MEDICAID SERVICES 1984-11 /pmc/articles/PMC4195108/ /pubmed/10311077 Text en |
spellingShingle | Research Articles Kominski, Gerald F. Williams, Sankey V. Mays, Randall B. Pickens, Gary T. Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title | Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title_full | Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title_fullStr | Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title_full_unstemmed | Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title_short | Unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
title_sort | unrecognized redistributions of revenue in diagnosis-related group-based prospective payment systems |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195108/ https://www.ncbi.nlm.nih.gov/pubmed/10311077 |
work_keys_str_mv | AT kominskigeraldf unrecognizedredistributionsofrevenueindiagnosisrelatedgroupbasedprospectivepaymentsystems AT williamssankeyv unrecognizedredistributionsofrevenueindiagnosisrelatedgroupbasedprospectivepaymentsystems AT maysrandallb unrecognizedredistributionsofrevenueindiagnosisrelatedgroupbasedprospectivepaymentsystems AT pickensgaryt unrecognizedredistributionsofrevenueindiagnosisrelatedgroupbasedprospectivepaymentsystems |