Uncompensated care pools and care to the uninsured: lessons from the New York Prospective Hospital Reimbursement Methodology.
One policy response to both the growing number of uninsured and the increased volume of uncompensated care is the development of revenue pools to explicitly finance uncompensated care. Despite the growing popularity of this response, few analyses have examined their success in financing uncompensated care and improving access to the uninsured. This study examines one such program developed as part of New York State's all-payer rate-setting system. The results indicate that the revenue pools improved the financial condition of New York hospitals but were less effective in improving access to care by the uninsured. The latter result was traced to the method selected by New York to measure "need" and distribute payments to hospitals. If the goal of such programs is to earmark payments to the uninsured, methods other than the New York system should be employed.
Thorpe
K E
KE
Department of Health Policy and Management, School of Public Health, Harvard University, Boston, MA 02115.
D003625:Data Collection; D004469:Economics, Hospital / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000639:trends; D007182:Income; D015271:Insurance Pools; D007350:Insurance, Hospitalization / Q000706:statistics & numerical data; D008489:Medical Indigency / Q000191:economics*; D009518:New York; D011445:Prospective Payment System