Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/162045
Authors: 
Wohlschlegel, Ansgar
Feess, Eberhard
Mueller, Helge
Year of Publication: 
2017
Series/Report no.: 
Beiträge zur Jahrestagung des Vereins für Socialpolitik 2016: Demographischer Wandel - Session: Health I B09-V2
Abstract: 
We use data from a German health insurer to study how the impact of switching from a fee for service system (FFS) to a high powered incentive scheme (prospective payment system; PPS) depends on the characteristics of patients and hospitals. As hospitals had a transition period of several years to complete the switch, we can adopt a difference-in-differences approach by adding hospital fixed effects and a time trend. Our results support hypotheses drawn from an incentive and selection perspective: PPS reduces the length of stay of older relative to younger patients, of more severe relative to less severe cases, and in smaller relative to larger hospitals. Hospitals which adopted PPS earlier provide higher quality under PPS as proxied by the case-specific readmission rate.
Subjects: 
Hospital reimbursement
high-powered incentives
readmission
length of stay
difference-in-differences estimation
JEL: 
I11
D22
I18
Document Type: 
Conference Paper

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