Medicare's disproportionate share adjustment and the cost of low-income patients.
We investigated whether or not hospitals have higher costs for inpatient care provided low-income Medicare patients, after controlling for other cost differences already accounted for by Medicare payments. We estimated differences in Prospective Payment System-adjusted costs and outlier-adjusted length of stay for low-income patients relative to matching non-low-income cases from the same hospital in 85 high-volume diagnosis-related groups (N = 1,247,670). Low-income Medicare patients do not have costlier hospital stays, although their stays are 2.5% longer. We conclude that disproportionate share payments are not justified on grounds of higher treatment costs.
Kominski
G F
GF
UCLA, Los Angeles, CA 90095, USA. kominski@ucla.edu
Long
S H
SH
D017281:Cost of Illness; D006302:Health Services Research; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016344:Medicare Part A / Q000191:economics / Q000706:statistics & numerical data*; D010351:Patient Discharge; D011203:Poverty / Q000706:statistics & numerical data*; D011445:Prospective Payment System / Q000191:economics* / Q000706:statistics & numerical data; D012044:Regression Analysis; D014481:United States