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Has inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates has widened?

Thomas Selden, Zeynal Karaca and Sandra Decker ()
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Zeynal Karaca: Agency for Healthcare Research and Quality
Sandra Decker: Agency for Healthcare Research and Quality

International Journal of Health Economics and Management, 2018, vol. 18, issue 4, No 4, 409-423

Abstract: Abstract The past decade witnessed a dramatic increase in inpatient hospital payment rates for patients with private insurance relative to payment rates for those covered by Medicare. A natural question is whether the widening private-Medicare payment rate difference had implications for the hospital care received by patients just before and after turning 65—the age at which there is a substantial shift from private to Medicare coverage. Using a large discharge dataset covering the period 2001–2011, we tracked changes at age 65 in the following dimensions of hospital care: overall hospitalization rates, case mix, referral-sensitive surgeries, length of stay, full established charges, number of procedures, mortality, and composite measures of inpatient quality and patient safety. In all cases we found either no change or a change that was small and inconsistent with payment rate changes during the study period.

Keywords: Hospital payment; Medicare; Private insurance (search for similar items in EconPapers)
JEL-codes: I13 I18 (search for similar items in EconPapers)
Date: 2018
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DOI: 10.1007/s10754-018-9240-5

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