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The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis

OBJECTIVE: To evaluate the impact of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. DATA SOURCES: Centers for Medicare & Medicaid Services Hospital Cost Reports and MSSP Accountable Care Organizations (ACO) Provider‐Level Research Iden...

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Autores principales: Huang, Huang, Zhu, Xi, Ullrich, Fred, MacKinney, A. Clinton, Mueller, Keith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9836956/
https://www.ncbi.nlm.nih.gov/pubmed/36214129
http://dx.doi.org/10.1111/1475-6773.14085
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author Huang, Huang
Zhu, Xi
Ullrich, Fred
MacKinney, A. Clinton
Mueller, Keith
author_facet Huang, Huang
Zhu, Xi
Ullrich, Fred
MacKinney, A. Clinton
Mueller, Keith
author_sort Huang, Huang
collection PubMed
description OBJECTIVE: To evaluate the impact of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. DATA SOURCES: Centers for Medicare & Medicaid Services Hospital Cost Reports and MSSP Accountable Care Organizations (ACO) Provider‐Level Research Identifiable File from 2011 to 2018. STUDY DESIGN: We used an event‐study design to estimate the temporal effects of MSSP participation on hospital financial outcomes and compared within‐hospital changes over time between MSSP and non‐MSSP hospitals while controlling for hospital and year fixed effects and organizational and service‐area characteristics. The following financial outcomes were evaluated: outpatient revenue, inpatient revenue, net patient revenue, Medicare revenue, operating margin, inpatient revenue share, Medicare revenue share, and allowance and discount rate. DATA COLLECTION/EXTRACTION METHODS: Secondary data linked at the hospital level. PRINCIPAL FINDINGS: Controlling for trends in non‐MSSP hospitals, MSSP participation was associated with differential increases in net patient revenue by $3.28 million (p < 0.001), $3.20 million (p < 0.01), and $4.20 million (p < 0.01) in the second, third, and fourth year and beyond after joining MSSP, respectively. Medicare revenue differentially increased by $1.50 million (p < 0.05), $2.24 million (p < 0.05), and $4.47 million (p < 0.05) in the first, second, and fourth year and beyond. Inpatient revenue share differentially increased by 0.29% (p < 0.05) in the second year and 0.44% (p < 0.05) in the fourth year and beyond. Medicare revenue share differentially increased by 0.17% (p < 0.01), 0.25% (p < 0.01), 0.32% (p < 0.01), and 0.41% (p < 0.01) in consecutive years following MSSP participation. MSSP participation was associated with 0.33% (p < 0.05) and 0.39% (p < 0.05) differential reduction in allowance and discount rate in the second and third years. CONCLUSIONS: MSSP participation was associated with differential increases in net patient revenue, Medicare revenue, inpatient revenue share, and Medicare revenue share, and a differential reduction in allowance and discount rate.
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spelling pubmed-98369562023-01-17 The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis Huang, Huang Zhu, Xi Ullrich, Fred MacKinney, A. Clinton Mueller, Keith Health Serv Res Hospital Finances OBJECTIVE: To evaluate the impact of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. DATA SOURCES: Centers for Medicare & Medicaid Services Hospital Cost Reports and MSSP Accountable Care Organizations (ACO) Provider‐Level Research Identifiable File from 2011 to 2018. STUDY DESIGN: We used an event‐study design to estimate the temporal effects of MSSP participation on hospital financial outcomes and compared within‐hospital changes over time between MSSP and non‐MSSP hospitals while controlling for hospital and year fixed effects and organizational and service‐area characteristics. The following financial outcomes were evaluated: outpatient revenue, inpatient revenue, net patient revenue, Medicare revenue, operating margin, inpatient revenue share, Medicare revenue share, and allowance and discount rate. DATA COLLECTION/EXTRACTION METHODS: Secondary data linked at the hospital level. PRINCIPAL FINDINGS: Controlling for trends in non‐MSSP hospitals, MSSP participation was associated with differential increases in net patient revenue by $3.28 million (p < 0.001), $3.20 million (p < 0.01), and $4.20 million (p < 0.01) in the second, third, and fourth year and beyond after joining MSSP, respectively. Medicare revenue differentially increased by $1.50 million (p < 0.05), $2.24 million (p < 0.05), and $4.47 million (p < 0.05) in the first, second, and fourth year and beyond. Inpatient revenue share differentially increased by 0.29% (p < 0.05) in the second year and 0.44% (p < 0.05) in the fourth year and beyond. Medicare revenue share differentially increased by 0.17% (p < 0.01), 0.25% (p < 0.01), 0.32% (p < 0.01), and 0.41% (p < 0.01) in consecutive years following MSSP participation. MSSP participation was associated with 0.33% (p < 0.05) and 0.39% (p < 0.05) differential reduction in allowance and discount rate in the second and third years. CONCLUSIONS: MSSP participation was associated with differential increases in net patient revenue, Medicare revenue, inpatient revenue share, and Medicare revenue share, and a differential reduction in allowance and discount rate. Blackwell Publishing Ltd 2022-10-17 2023-02 /pmc/articles/PMC9836956/ /pubmed/36214129 http://dx.doi.org/10.1111/1475-6773.14085 Text en © 2022 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Hospital Finances
Huang, Huang
Zhu, Xi
Ullrich, Fred
MacKinney, A. Clinton
Mueller, Keith
The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title_full The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title_fullStr The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title_full_unstemmed The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title_short The impact of Medicare shared savings program participation on hospital financial performance: An event‐study analysis
title_sort impact of medicare shared savings program participation on hospital financial performance: an event‐study analysis
topic Hospital Finances
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9836956/
https://www.ncbi.nlm.nih.gov/pubmed/36214129
http://dx.doi.org/10.1111/1475-6773.14085
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