Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Case shifting and the Medicare Prospective Payment System.

F A Sloan1, M A Morrisey, J Valvona

  • 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama, Birmingham 35294.

American Journal of Public Health
|May 1, 1988
PubMed
Summary

The Medicare Prospective Payment System (PPS) saw stable Medicare discharges but an increase in uninsured patients. Hospital case mix complexity and severity rose, with more Medicare patients using emergency rooms.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis.

Journal of dental research·2023
Same author

Mothers and fathers in the criminal justice system and children's child protective services involvement.

Child abuse & neglect·2020
Same author

The effects of state-level expenditures for home- and community-based services on the risk of becoming a long-stay nursing home resident after hip fracture.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·2015
Same author

Mortality following bone metastasis and skeletal-related events among men with prostate cancer: a population-based analysis of US Medicare beneficiaries, 1999-2006.

Prostate cancer and prostatic diseases·2011
Same author

Heavy drinking in early adulthood and outcomes at mid life.

Journal of epidemiology and community health·2010
Same author

Clinical and demographic factors associated with fractures among older Americans.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·2010

Area of Science:

  • Health Services Research
  • Healthcare Policy
  • Hospital Administration

Background:

  • The Medicare Prospective Payment System (PPS) was implemented in 1984 to control healthcare costs.
  • Understanding the initial impacts of PPS on hospital operations and patient demographics is crucial for policy evaluation.

Purpose of the Study:

  • To assess the effects of the Medicare Prospective Payment System (PPS) during its initial two years (1984-85) on hospital operations and patient characteristics.
  • To analyze changes in discharge rates, patient mix, case severity, and emergency room utilization post-PPS implementation.

Main Methods:

  • Utilized data from the Commission on Professional and Hospital Activities and the American Hospital Association for 467 hospitals.
  • Compared hospital data from 1983-1985 to evaluate trends before and after PPS implementation.

Related Experiment Videos

  • Analyzed Medicare discharges as a percentage of total discharges, uninsured patient rates, discharge volumes, diagnosis-related group (DRG) complexity, and emergency room admission patterns.

    • Main Results:

    • Medicare discharges as a percentage of total discharges remained constant, but the proportion of uninsured patients increased, particularly in large public hospitals.
    • Both Medicare and total hospital discharges per facility declined.
    • An increase in complex diagnosis-related groups (DRGs) and case mix severity was observed, a trend that predated PPS but continued afterward. Medicare emergency room admissions rose, while non-Medicare admissions remained stable.

    Conclusions:

    • While PPS implementation coincided with shifts in patient demographics and utilization, some trends like increasing case mix complexity began before its introduction.
    • The rise in uninsured and Medicare emergency room admissions warrants continued monitoring for potential PPS influence.
    • The study highlights the complex interplay of factors affecting hospitals during the early stages of PPS adoption.