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Record W2986075423 · doi:10.3386/w26455

How do Hospitals Respond to Payment Incentives?

2019· report· en· W2986075423 on OpenAlexaff
Gautam Gowrisankaran, Keith A. Joiner, Jianjing Lin

Bibliographic record

VenueNational Bureau of Economic Research · 2019
Typereport
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsHEC Montréal
Fundersnot available
KeywordsReimbursementIncentivePaymentRevenueActuarial scienceCoding (social sciences)BusinessMedical diagnosisMedical recordMedical classificationDiagnosis codeMedical costsProspective payment systemFinanceMedicineEconomicsNursingHealth careEnvironmental health

Abstract

fetched live from OpenAlex

Over the past decades, Medicare has developed payment reforms that incentivize quality care, by reimbursing fixed amounts for ex ante similar patients.While these reforms may add value, they require providers to code more information on patient health conditions, which is costly.We evaluate the role of revenues and costs in coding intensity for Medicare hospitalized inpatients.We examine the role of costs by estimating hospitals' changes in coding intensity following a 2007 reform based on whether they had adopted electronic medical records (EMRs).EMR hospitals documented relatively more top billing codes after the reform with the increase occurring only for non-surgical admissions, consistent with the hypotheses that costs became an important determinant of the coding decision and EMRs lower these costs, particularly for medical admissions.We further examine whether increased reimbursements from reporting complex diagnoses led hospitals to report more of these diagnoses.We find evidence in favor of this hypothesis before the reform but not after, suggesting that increased billing complexity postreform made coding costs a more important driver of coding decisions.Our findings suggests that recent payment innovations might add cost to providers, who may want to consider reimbursements in their technology adoption and usage decisions.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.012
metaresearch head score (Gemma)0.100
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.012
Threshold uncertainty score0.062

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0120.100
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.002
Science and technology studies0.0010.001
Scholarly communication0.0060.005
Open science0.0010.003
Research integrity0.0040.003
Insufficient payload (model declined to judge)0.0090.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.430
GPT teacher head0.512
Teacher spread0.082 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations7
Published2019
Admission routes1
Has abstractyes

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