| Inefficiency differences between critical access hospitals and prospectively paid rural hospitals. | |
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MedLine Citation:
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PMID: 20159848 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The Medicare prospective payment system (PPS) contains incentives for hospitals to improve efficiency by placing them at financial risk to earn a positive margin on services rendered to Medicare patients. Concerns about the financial viability of small rural hospitals led to the implementation of the Medicare Rural Hospital Flexibility Program (Flex Program) of 1997, which allows facilities designated as critical access hospitals (CAHs) to be paid on a reasonable cost basis for inpatient and outpatient services. This article compares the cost inefficiency of CAHs with that of nonconverting rural hospitals to contrast the performance of hospitals operating under the different payment systems. Stochastic frontier analysis (SFA) was used to estimate cost inefficiency. Analysis was performed on pooled time-series, cross-sectional data from thirty-four states for the period 1997-2004. Average estimated cost inefficiency was greater in CAHs (15.9 percent) than in nonconverting rural hospitals (10.3 percent). Further, there was a positive association between length of time in the CAH program and estimated cost inefficiency. CAHs exhibited poorer values for a number of proxy measures for efficiency, including expenses per admission and labor productivity (full-time-equivalent employees per outpatient-adjusted admission). Non-CAH rural hospitals had a stronger correlation between cost inefficiency and operating margin than CAH facilities did. |
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Authors:
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Michael D Rosko; Ryan L Mutter |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of health politics, policy and law Volume: 35 ISSN: 1527-1927 ISO Abbreviation: J Health Polit Policy Law Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-17 Completed Date: 2010-03-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609331 Medline TA: J Health Polit Policy Law Country: United States |
Other Details:
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Languages: eng Pagination: 95-126 Citation Subset: IM |
Affiliation:
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Widener University. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Costs and Cost Analysis Cross-Sectional Studies Efficiency, Organizational / economics* Emergency Service, Hospital / economics, organization & administration* Financial Management, Hospital / organization & administration* Hospitals, Rural / economics, organization & administration* Humans Medicare / economics Prospective Payment System* Regional Medical Programs / economics United States |
| Grant Support | |
ID/Acronym/Agency:
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290-00-0004//PHS HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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