Medicare prospective payment without separate urban and rural rates.
O'Dougherty, Sheila M
Date of Pub
Ault, Thomas; Cotterill, Philip G; DeLew, Nancy; Phillips, Steven M; Richter, Elizabeth; Wynn, Barbara
The elimination of urban-rural differences in the Medicare prospective payment system (PPS) standard rates implies a need
to re-examine all the PPS payment adjustments. Refinements for case mix, outliers, and the wage index can make a significant
contribution to avoiding payment disparities in a single-rate system. However, changes in the adjustments for teaching and
disproportionate-share (DSH) hospitals are also needed. The typically urban location of these hospitals makes it difficult
to balance PPS payments and costs among major groups of urban and rural hospitals without some form of higher payment for
all hospitals located in large urban areas.
Diagnosis-Related Groups/economics : Hospitals, Rural/economics : Hospitals, Teaching/economics : Hospitals, Urban/economics
: Medicare Part A/economics/statistics & numerical data : Outliers, DRG/economics : Prospective Payment System/standards :
Rate Setting and Review/standards : Regression Analysis : United States