دانلود مقاله ISI انگلیسی شماره 102929
ترجمه فارسی عنوان مقاله

تأثیرات اصلاحات پرداخت در مقایسه با بازارهای کمتر رقابتی

عنوان انگلیسی
Effects of payment reform in more versus less competitive markets
کد مقاله سال انتشار تعداد صفحات مقاله انگلیسی
102929 2017 18 صفحه PDF
منبع

Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)

Journal : Journal of Health Economics, Volume 51, January 2017, Pages 66-83

پیش نمایش مقاله
پیش نمایش مقاله  تأثیرات اصلاحات پرداخت در مقایسه با بازارهای کمتر رقابتی

چکیده انگلیسی

Policymakers are increasingly interested in reducing healthcare costs and inefficiencies through innovative payment strategies. These strategies may have heterogeneous impacts across geographic areas, potentially reducing or exacerbating geographic variation in healthcare spending. In this paper, we exploit a major payment reform for home health care to examine whether reductions in reimbursement lead to differential changes in treatment intensity and provider costs depending on the level of competition in a market. Using Medicare claims, we find that while providers in more competitive markets had higher average costs in the pre-reform period, these markets experienced larger proportional reductions in treatment intensity and costs after the reform relative to less competitive markets. This led to a convergence in spending across geographic areas. We find that much of the reduction in provider costs is driven by greater exit of “high-cost” providers in more competitive markets.