Hospital Admissions, Length of Stay, and Case-Mix Impacts of Per Case Payment: the Maryland Experience

36 Pages Posted: 26 May 2004 Last revised: 1 Jul 2010

See all articles by David S. Salkever

David S. Salkever

UMBC, Department of Public Policy

Donald M. Steinwachs

Johns Hopkins University - Department of Health Policy and Management; National Bureau of Economic Research (NBER)

Date Written: August 1986

Abstract

Maryland has simultaneously operated per case - and per service hospital payment systems since 1976 with varying levels of stringency in setting per case rates. Regression analyses of this experience are used to compare the impacts of these systems on admissions, length of stay, and case-mix costliness for the period July 1, 1976 to June 30, 1981. Our results indicate a positive effect on admissions and negative effects on case-mix and length of stay for the per case payment approach relative to the per service approach. More stringent levels of per case payment are associated with stronger utilization responses.

Suggested Citation

Salkever, David S. and Steinwachs, Donald M., Hospital Admissions, Length of Stay, and Case-Mix Impacts of Per Case Payment: the Maryland Experience (August 1986). NBER Working Paper No. w2010. Available at SSRN: https://ssrn.com/abstract=344806

David S. Salkever (Contact Author)

UMBC, Department of Public Policy ( email )

1000 Hilltop Circle
Baltimore, MD 21250

Donald M. Steinwachs

Johns Hopkins University - Department of Health Policy and Management

624 North Broadway
Baltimore, MD 21205

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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