Do Chargemaster Prices Matter
An Examination of Acute Care Hospital Profitability
Datos Bibliográficos
| ID | 9099896 |
|---|---|
| Autores | Sebastian Linde (0000-0002-7209-0143, Medical College of Wisconsin, autor de correspondencia), L E Egede (0000-0003-1546-1515, Medical College of Wisconsin, autor de correspondencia) |
| Año | 2022 |
| Volumen | 60 |
| Número | 8 |
| Páginas | 623-630 |
| Fecha de publicación | 2022-08-01 |
| Peer Reviewed | Sí |
| Open Access | No |
| Tipo | ARTICLE |
| Revista | Medical Care (JOURNAL) |
| Identificadores de la revista | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Editorial | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001734 |
| PMID | 35647741 |
| OpenAlex | W4281713390 |
| Idioma | EN |
| Referencias citadas | 27 |
BACKGROUND: It remains widely debated whether chargemaster price markups are tied to hospital profitability. OBJECTIVE: To evaluate the effect of chargemaster markups on hospital profitability in the presence of unobserved hospital-specific (time-invariant) confounders, and cross-sectional dependence due to latent (common) policy shocks. DESIGN: We use interactive fixed effects methods to address concerns of unobserved hospital-specific (time-invariant) confounders, and cross-sectional dependence. SETTING: US acute care hospitals, 1996 through 2017 (ie, 22 y). PARTICIPANTS: Using primarily Medicare cost report data, we construct an unbalanced panel of 3499 acute care hospitals per year, or a total of 76,972 hospital-year observations. MEASUREMENTS: Chargemaster markups (above cost), profits per hospital inpatient discharge. RESULTS: Between 1996 and 2017, chargemaster markups increased (on average) by 155%, and the SD of the chargemaster markup distribution increased by 324%-indicating growing variability in the average markup strategies pursued by hospitals. Our preferred model specification implies that a unit increase of the hospital chargemaster markup is associated with a $261 ( P <0.01; 95% confidence interval: $232-$291) increase in profits per hospital inpatient discharge. These results are robust to a wide set of model specifications, the use of alternative profitability measurements, and the use of an alternative instrumental variable identification strategy. Additional subsample analysis that controls for a rich set of hospital quality measures and system affiliation information also yields similar results. CONCLUSION: We show that higher chargemaster markups are associated with higher hospital profitability. Additional research is needed to understand how chargemaster pricing impact health outcomes and health care disparities
Actuarial science · Acute care · Confidence interval · Confounding · Econometrics · Economics · Health care · Panel data · Profitability index · Emergency Medicine · Finance · Healthcare Policy and Management · Heart Failure Treatment and Management · Medicine · Primary Care and Health Outcomes
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| Velocidad de citación | historical |
|---|---|
| Altamente citado | No |