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Volumn 36, Issue 4, 2017, Pages 689-696

Mystery of the chargemaster: Examining the role of hospital list prices in what patients actually pay

Author keywords

[No Author keywords available]

Indexed keywords

BEHAVIOR; CALIFORNIA; HOSPITAL; HUMAN; MARKET; MEDICALLY UNINSURED; COMMUNITY CARE; HEALTH CARE COST; HEALTH ECONOMICS; HOSPITAL CHARGE;

EID: 85017139504     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2016.0986     Document Type: Article
Times cited : (51)

References (24)
  • 1
    • 32044444367 scopus 로고    scopus 로고
    • The precarious pricing system for hospital services
    • Tompkins CP, Altman SH, Eilat E. The precarious pricing system for hospital services. Health Aff (Millwood). 2006;25(1):45-56
    • (2006) Health Aff (Millwood) , vol.25 , Issue.1 , pp. 45-56
    • Tompkins, C.P.1    Altman, S.H.2    Eilat, E.3
  • 2
    • 32044433779 scopus 로고    scopus 로고
    • The pricing of U.S. hospital services: chaos behind a veil of secrecy
    • Reinhardt UE. The pricing of U.S. hospital services: chaos behind a veil of secrecy. Health Aff (Millwood). 2006;25(1):57-69
    • (2006) Health Aff (Millwood) , vol.25 , Issue.1 , pp. 57-69
    • Reinhardt, U.E.1
  • 3
    • 34248576156 scopus 로고    scopus 로고
    • From "soak the rich" to "soak the poor": recent trends in hospital pricing
    • Anderson GF. From "soak the rich" to "soak the poor": recent trends in hospital pricing. Health Aff (Millwood). 2007;26(3):780-9
    • (2007) Health Aff (Millwood) , vol.26 , Issue.3 , pp. 780-789
    • Anderson, G.F.1
  • 4
    • 84930897735 scopus 로고    scopus 로고
    • Extreme markup: the fifty US hospitals with the highest charge-to-cost ratios
    • Bai G, Anderson GF. Extreme markup: the fifty US hospitals with the highest charge-to-cost ratios. Health Aff (Millwood). 2015; 34(6):922-8
    • (2015) Health Aff (Millwood) , vol.34 , Issue.6 , pp. 922-928
    • Bai, G.1    Anderson, G.F.2
  • 7
    • 85017149158 scopus 로고    scopus 로고
    • In some cases, hospitals provide free or discounted care to a subset of uninsured patients who qualify for their charity care policies, though that is typically at the discretion of the hospital. And some states have enacted regulations that limit charges to a broader range of uninsured and out-of-network patients
    • In some cases, hospitals provide free or discounted care to a subset of uninsured patients who qualify for their charity care policies, though that is typically at the discretion of the hospital. And some states have enacted regulations that limit charges to a broader range of uninsured and out-of-network patients
  • 8
    • 85009964431 scopus 로고    scopus 로고
    • In the shadow of a giant: Medicare's influence on private payment systems
    • Clemens J, Gottlieb JD. In the shadow of a giant: Medicare's influence on private payment systems. J Polit Econ. 2017;125(1):1-39
    • (2017) J Polit Econ , vol.125 , Issue.1 , pp. 1-39
    • Clemens, J.1    Gottlieb, J.D.2
  • 9
    • 85017131840 scopus 로고    scopus 로고
    • Specifically, DRG 470, major joint replacement or reattachment of the lower extremity without major complications
    • Specifically, DRG 470, major joint replacement or reattachment of the lower extremity without major complications
  • 10
    • 85017153953 scopus 로고    scopus 로고
    • CMS recognizes legitimate reasons for price variation, such as local labor costs, and reimburses hospitals accordingly. However, the degree of variation in the fraction of these charges that CMS pays for hip replacements is only slightly smaller: The twenty-fifth and seventy-fifth percentiles of 22 percent and 38 percent
    • CMS recognizes legitimate reasons for price variation, such as local labor costs, and reimburses hospitals accordingly. However, the degree of variation in the fraction of these charges that CMS pays for hip replacements is only slightly smaller: The twenty-fifth and seventy-fifth percentiles of 22 percent and 38 percent
  • 11
    • 85017142218 scopus 로고    scopus 로고
    • Since 2012 the NIS has suppressed hospital identifiers, making it impossible to link hospitals over time
    • Since 2012 the NIS has suppressed hospital identifiers, making it impossible to link hospitals over time
  • 12
    • 84969141770 scopus 로고    scopus 로고
    • A more detailed understanding of factors associated with hospital profitability
    • Bai G, Anderson GF. A more detailed understanding of factors associated with hospital profitability. Health Aff (Millwood). 2016;35(5):889-97
    • (2016) Health Aff (Millwood) , vol.35 , Issue.5 , pp. 889-897
    • Bai, G.1    Anderson, G.F.2
  • 13
    • 85017157143 scopus 로고    scopus 로고
    • To access the Appendix, click on the Appendix link in the box to the right of the article online
    • To access the Appendix, click on the Appendix link in the box to the right of the article online
  • 14
    • 84860369134 scopus 로고    scopus 로고
    • Lebanon (NH): Dartmouth Institute, [cited 2017 Mar 10]
    • Dartmouth Institute for Health Policy and Clinical Practice. Dartmouth atlas of health care [home page on the Internet]. Lebanon (NH): Dartmouth Institute; [cited 2017 Mar 10]. Available from: http://www.dart mouthatlas.org
    • Dartmouth atlas of health care [home page on the Internet]
  • 15
    • 84879259385 scopus 로고    scopus 로고
    • Fair pricing law prompts most California hospitals to adopt policies to protect uninsured patients from high charges
    • Melnick G, Fonkych K. Fair pricing law prompts most California hospitals to adopt policies to protect uninsured patients from high charges. Health Aff (Millwood). 2013;32(6): 1101-8
    • (2013) Health Aff (Millwood) , vol.32 , Issue.6 , pp. 1101-1108
    • Melnick, G.1    Fonkych, K.2
  • 16
    • 84920903417 scopus 로고    scopus 로고
    • California's Hospital Fair Pricing Act reduced the prices actually paid by uninsured patients
    • Bai G. California's Hospital Fair Pricing Act reduced the prices actually paid by uninsured patients. Health Aff (Millwood). 2015;34(1): 64-70
    • (2015) Health Aff (Millwood) , vol.34 , Issue.1 , pp. 64-70
    • Bai, G.1
  • 17
    • 85017102423 scopus 로고    scopus 로고
    • Financial incentives, hospital care, and health outcomes: evidence from fair pricing laws
    • Batty MM, Ippolito BN. Financial incentives, hospital care, and health outcomes: evidence from fair pricing laws. Am Econ J Econ Policy. Forthcoming
    • Am Econ J Econ Policy. Forthcoming
    • Batty, M.M.1    Ippolito, B.N.2
  • 18
    • 85017188618 scopus 로고    scopus 로고
    • The size classification is defined relative to a hospital's type. For instance, an urban teaching hospital in the Northeast must have at least 400 beds to be considered large, while a rural hospital from the South needs only 75 beds to be classified as such
    • The size classification is defined relative to a hospital's type. For instance, an urban teaching hospital in the Northeast must have at least 400 beds to be considered large, while a rural hospital from the South needs only 75 beds to be classified as such
  • 19
    • 85017184310 scopus 로고    scopus 로고
    • Exhibit 3 shows that the relationship between charges and payments for hospitals in markets with abovemedian HHI was significantly smaller than that for hospitals in markets with below-median HHI.We also found a significant negative coefficient in models where charges were interacted with HHI (data not shown)
    • Exhibit 3 shows that the relationship between charges and payments for hospitals in markets with abovemedian HHI was significantly smaller than that for hospitals in markets with below-median HHI.We also found a significant negative coefficient in models where charges were interacted with HHI (data not shown)
  • 20
    • 85017129827 scopus 로고    scopus 로고
    • The Dartmouth Atlas of Health Care provides two definitions of hospital market that can be used to study concentration: HRRs (described in the text) and Health Service Areas (HSAs). It was not obvious which definition to use in this one-state setting. HRRs are large, and by this metric the vast majority of California hospitals are in nonconcentrated areas. In contrast, HSAs are sufficiently small that the majority of them have only one hospital. Both measures of market concentration indicate the amount of competition faced by a hospital. Therefore, our preferred measures of HHI and market share were averages of the HRR and HSA measures. For robustness, we tested a variety of weighted averages: The results were generally similar. See Note 14
    • The Dartmouth Atlas of Health Care provides two definitions of hospital market that can be used to study concentration: HRRs (described in the text) and Health Service Areas (HSAs). It was not obvious which definition to use in this one-state setting. HRRs are large, and by this metric the vast majority of California hospitals are in nonconcentrated areas. In contrast, HSAs are sufficiently small that the majority of them have only one hospital. Both measures of market concentration indicate the amount of competition faced by a hospital. Therefore, our preferred measures of HHI and market share were averages of the HRR and HSA measures. For robustness, we tested a variety of weighted averages: The results were generally similar. See Note 14
  • 21
    • 84950974095 scopus 로고    scopus 로고
    • The growing difference between public and private payment rates for inpatient hospital care
    • Selden TM, Karaca Z, Keenan P, White C, Kronick R. The growing difference between public and private payment rates for inpatient hospital care. Health Aff (Millwood). 2015;34(12):2147-50
    • (2015) Health Aff (Millwood) , vol.34 , Issue.12 , pp. 2147-2150
    • Selden, T.M.1    Karaca, Z.2    Keenan, P.3    White, C.4    Kronick, R.5
  • 22
    • 84969141770 scopus 로고    scopus 로고
    • A more detailed understanding of factors associated with hospital profitability
    • Bai G, Anderson GF. A more detailed understanding of factors associated with hospital profitability. Health Aff (Millwood). 2016;35(5):889-97
    • (2016) Health Aff (Millwood) , vol.35 , Issue.5 , pp. 889-897
    • Bai, G.1    Anderson, G.F.2
  • 23
    • 85017186426 scopus 로고    scopus 로고
    • Authors' calculations using data from the Medical Expenditure Panel Survey for the period 2000-04, excluding separately billing physicians. These years represent the latest years before the start of a wave of state laws that limit payments from the uninsured
    • Authors' calculations using data from the Medical Expenditure Panel Survey for the period 2000-04, excluding separately billing physicians. These years represent the latest years before the start of a wave of state laws that limit payments from the uninsured
  • 24
    • 32044444367 scopus 로고    scopus 로고
    • The precarious pricing system for hospital services
    • Tompkins CP, Altman SH, Eilat E. The precarious pricing system for hospital services. Health Aff (Millwood). 2006;25(1): 45-56
    • (2006) Health Aff (Millwood) , vol.25 , Issue.1 , pp. 45-56
    • Tompkins, C.P.1    Altman, S.H.2    Eilat, E.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.