Hospital Financial Pressures and the Health of the Uninsured: Who Gets Hurt? The Case of California
24 Pages Posted: 23 Apr 2009 Last revised: 19 May 2009
Date Written: March 2, 2009
Abstract
The US relies on charitable medical care to serve the uninsured, most of which is offered by hospitals that act as providers of last resort and that constitute the safety net. This paper analyzes the effect that hospital financial stress has on the health of the uninsured. In particular we look at managed care. Managed care penetration has often been blamed for increasing financial pressures on hospitals and previous work has showed that safety net hospitals have been affected more severely by it. Our findings are threefold: first, we find that managed care financial pressures encourage charity care patients to concentrate in public hospitals. Second, we fins that these hospitals, in turn, see a decrease in their quality of care in areas where managed care penetration is stronger. Finally we also find that managed care diffusion has a negative effect on the quality of care received by the uninsured - as measured by the probability of dying after a heart attack - and of those that go to government hospitals.
Keywords: uninsured, hospitals, financial care, quality
Suggested Citation: Suggested Citation
Do you have a job opening that you would like to promote on SSRN?
Recommended Papers
-
Hmos and Fee-for-Service Health Care Expenditures: Evidence from Medicare
-
By Tom Getzen
-
The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare
-
What Did Medicare Do (and Was it Worth it)?
By Amy Finkelstein and Robin Mcknight
-
Managed Care and Health Care Expenditures: Evidence from Medicare
-
The Effect of Medicare Part D on Pharmaceutical Prices and Utilization
By Mark Duggan and Fiona M. Scott Morton
-
Does Contracting Out Increase the Efficiency of Government Programs? Evidence from Medicaid Hmos
By Mark Duggan
-
Do Investors Forecast Fat Firms? Evidence from the Gold Mining Industry
By Severin Borenstein and Joseph Farrell
-
Hospitals, Managed Care, and the Charity Caseload in California
By Janet Currie and John Fahr