Journal article
The impact of Medicare shared savings program participation on hospital financial performance: An event-study analysis
Health services research, Vol.58(1), pp.116-127
02/2023
DOI: 10.1111/1475-6773.14085
PMCID: PMC9836956
PMID: 36214129
Appears in UI Libraries Support Open Access
Abstract
OBJECTIVETo evaluate the impact of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. DATA SOURCESCenters for Medicare & Medicaid Services Hospital Cost Reports and MSSP Accountable Care Organizations (ACO) Provider-Level Research Identifiable File from 2011 to 2018. STUDY DESIGNWe used an event-study design to estimate the temporal effects of MSSP participation on hospital financial outcomes and compared within-hospital changes over time between MSSP and non-MSSP hospitals while controlling for hospital and year fixed effects and organizational and service-area characteristics. The following financial outcomes were evaluated: outpatient revenue, inpatient revenue, net patient revenue, Medicare revenue, operating margin, inpatient revenue share, Medicare revenue share, and allowance and discount rate. DATA COLLECTION/EXTRACTION METHODSSecondary data linked at the hospital level. PRINCIPAL FINDINGSControlling for trends in non-MSSP hospitals, MSSP participation was associated with differential increases in net patient revenue by $3.28 million (p < 0.001), $3.20 million (p < 0.01), and $4.20 million (p < 0.01) in the second, third, and fourth year and beyond after joining MSSP, respectively. Medicare revenue differentially increased by $1.50 million (p < 0.05), $2.24 million (p < 0.05), and $4.47 million (p < 0.05) in the first, second, and fourth year and beyond. Inpatient revenue share differentially increased by 0.29% (p < 0.05) in the second year and 0.44% (p < 0.05) in the fourth year and beyond. Medicare revenue share differentially increased by 0.17% (p < 0.01), 0.25% (p < 0.01), 0.32% (p < 0.01), and 0.41% (p < 0.01) in consecutive years following MSSP participation. MSSP participation was associated with 0.33% (p < 0.05) and 0.39% (p < 0.05) differential reduction in allowance and discount rate in the second and third years. CONCLUSIONSMSSP participation was associated with differential increases in net patient revenue, Medicare revenue, inpatient revenue share, and Medicare revenue share, and a differential reduction in allowance and discount rate.
Details
- Title: Subtitle
- The impact of Medicare shared savings program participation on hospital financial performance: An event-study analysis
- Creators
- Huang Huang - University of IowaXi Zhu - University of California, Los AngelesFred Ullrich - University of IowaA Clinton MacKinney - University of IowaKeith Mueller - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.58(1), pp.116-127
- Publisher
- Wiley
- DOI
- 10.1111/1475-6773.14085
- PMID
- 36214129
- PMCID
- PMC9836956
- eISSN
- 1475-6773
- Grant note
- DOI: 10.13039/100010001, name: Federal Office of Rural Health Policy, award: U1C RH20419; DOI: 10.13039/100000102, name: Health Resources and Services Administration; DOI: 10.13039/100000016, name: U.S. Department of Health and Human Services
- Language
- English
- Electronic publication date
- 10/10/2022
- Date published
- 02/2023
- Academic Unit
- Health Management and Policy; Public Policy Center (Archive)
- Record Identifier
- 9984306360202771
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