| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w23926 |
| 来源ID | Working Paper 23926 |
| Effects of Episode-Based Payment on Health Care Spending and Utilization: Evidence from Perinatal Care in Arkansas | |
| Caitlin Carroll; Michael Chernew; A. Mark Fendrick; Joe Thompson; Sherri Rose | |
| 发表日期 | 2017-10-16 |
| 出版年 | 2017 |
| 语种 | 英语 |
| 摘要 | We study how physicians respond to financial incentives imposed by episode-based bundled payment (EBP), which encourages lower spending and improved quality for an entire episode of care. Specifically, we study the impact of the Arkansas Health Care Payment Improvement Initiative, a multi-payer program that requires providers in the state to enter into EBP arrangements for perinatal care. Because of its multi-payer nature and the requirement that providers participate, the program covers the vast majority of births in the state. Unlike fee-for-service reimbursement, EBP holds physicians responsible for all care within a discrete clinical episode, rewarding physicians not only for efficient use of their own services but also for efficient management of other health care inputs. In a difference-in-differences analysis of commercial claims, we find that perinatal spending decreased by 3.8% overall in Arkansas after the introduction of EBP, compared to surrounding states. We find that the decrease was driven by reduced spending on non-physician health care inputs, specifically the prices paid for inpatient facility care, and that our results are robust to a number of sensitivity and placebo tests. We additionally find that EBP was associated with a limited improvement in quality of care. |
| 主题 | Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w23926 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/581599 |
| 推荐引用方式 GB/T 7714 | Caitlin Carroll,Michael Chernew,A. Mark Fendrick,et al. Effects of Episode-Based Payment on Health Care Spending and Utilization: Evidence from Perinatal Care in Arkansas. 2017. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w23926.pdf（613KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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