Payer mix & financial health drive hospital quality: Implications for value-based reimbursement policies

Documented disparities in health care quality in hospitals have been associated with patients’ race, gender, age, and insurance coverage. We used a novel data set with detailed hospital-level demographic, financial, quality-of-care, and outcome data across 265 California hospitals to examine the rel...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Behavioral science & policy 2015-04, Vol.1 (1), p.77-84
Hauptverfasser: Manary, Matthew, Staelin, Richard, Boulding, William, Glickman, Seth W.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext bestellen
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 84
container_issue 1
container_start_page 77
container_title Behavioral science & policy
container_volume 1
creator Manary, Matthew
Staelin, Richard
Boulding, William
Glickman, Seth W.
description Documented disparities in health care quality in hospitals have been associated with patients’ race, gender, age, and insurance coverage. We used a novel data set with detailed hospital-level demographic, financial, quality-of-care, and outcome data across 265 California hospitals to examine the relationship between a hospital's financial health and its quality of care. We found that payer mix, the percentage of patients with private insurance coverage, is the key driver of a hospital's financial health. This is important because a hospital's financial health influences its quality of care and patient outcomes. Government policies that financially penalize hospitals on the basis of care quality and/or outcomes may disproportionately impair financial performance and quality investments at hospitals serving fewer privately insured patients. Such policies could exacerbate health disparities among patients at greatest risk of receiving substandard care.
doi_str_mv 10.1177/237946151500100110
format Article
fullrecord <record><control><sourceid>proquest_AFRWT</sourceid><recordid>TN_cdi_proquest_journals_1760238283</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_237946151500100110</sage_id><sourcerecordid>3933538821</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2040-de413581305c67840ab2d52edddbd48b3f03de0cd66d976ebbf5ff690c1faffa3</originalsourceid><addsrcrecordid>eNp1kF9LwzAUxYMoOOa-gE8Bwbe6m6ZJOt9k6BwM9EGfS9rc2Iz-W9IO9-3tmIggwoV7OfzOuXAIuWZwx5hS85irRSKZYAKAjcPgjEyOYnRUz39uUJdkFsIWRkYyloCYkPJVH9DT2n3SW2pdo5vC6YqWqKu-pMa7PdKyDZ3rR3U36Mr1h3u6rrvKFbp3bROobT3d62rAKNcBDfXo6nzwAWtsetq1I-kwXJELq6uAs-89Je9Pj2_L52jzslovHzZREUMCkcGEcZEyDqKQKk1A57ERMRpjcpOkObfADUJhpDQLJTHPrbBWLqBgVlur-ZTcnHI73-4GDH22bQffjC8zpiTEPI1TPlLxiSp8G4JHm3Xe1dofMgbZsdTsb6mjaX4yBf2Bv2L_d3wBX5N4Pg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1760238283</pqid></control><display><type>article</type><title>Payer mix &amp; financial health drive hospital quality: Implications for value-based reimbursement policies</title><source>Sage Journals GOLD Open Access 2024</source><creator>Manary, Matthew ; Staelin, Richard ; Boulding, William ; Glickman, Seth W.</creator><creatorcontrib>Manary, Matthew ; Staelin, Richard ; Boulding, William ; Glickman, Seth W.</creatorcontrib><description>Documented disparities in health care quality in hospitals have been associated with patients’ race, gender, age, and insurance coverage. We used a novel data set with detailed hospital-level demographic, financial, quality-of-care, and outcome data across 265 California hospitals to examine the relationship between a hospital's financial health and its quality of care. We found that payer mix, the percentage of patients with private insurance coverage, is the key driver of a hospital's financial health. This is important because a hospital's financial health influences its quality of care and patient outcomes. Government policies that financially penalize hospitals on the basis of care quality and/or outcomes may disproportionately impair financial performance and quality investments at hospitals serving fewer privately insured patients. Such policies could exacerbate health disparities among patients at greatest risk of receiving substandard care.</description><identifier>ISSN: 2379-4607</identifier><identifier>EISSN: 2379-4615</identifier><identifier>DOI: 10.1177/237946151500100110</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Health care expenditures ; Insurance coverage ; Medicare ; Mortality ; Socioeconomic factors</subject><ispartof>Behavioral science &amp; policy, 2015-04, Vol.1 (1), p.77-84</ispartof><rights>2015 Behavioral Science &amp; Policy Association unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses.</rights><rights>Copyright Brookings Institution Press Spring 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2040-de413581305c67840ab2d52edddbd48b3f03de0cd66d976ebbf5ff690c1faffa3</citedby><cites>FETCH-LOGICAL-c2040-de413581305c67840ab2d52edddbd48b3f03de0cd66d976ebbf5ff690c1faffa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/237946151500100110$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/237946151500100110$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21945,27830,27901,27902,44921,45309</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/237946151500100110?utm_source=summon&amp;utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc></links><search><creatorcontrib>Manary, Matthew</creatorcontrib><creatorcontrib>Staelin, Richard</creatorcontrib><creatorcontrib>Boulding, William</creatorcontrib><creatorcontrib>Glickman, Seth W.</creatorcontrib><title>Payer mix &amp; financial health drive hospital quality: Implications for value-based reimbursement policies</title><title>Behavioral science &amp; policy</title><description>Documented disparities in health care quality in hospitals have been associated with patients’ race, gender, age, and insurance coverage. We used a novel data set with detailed hospital-level demographic, financial, quality-of-care, and outcome data across 265 California hospitals to examine the relationship between a hospital's financial health and its quality of care. We found that payer mix, the percentage of patients with private insurance coverage, is the key driver of a hospital's financial health. This is important because a hospital's financial health influences its quality of care and patient outcomes. Government policies that financially penalize hospitals on the basis of care quality and/or outcomes may disproportionately impair financial performance and quality investments at hospitals serving fewer privately insured patients. Such policies could exacerbate health disparities among patients at greatest risk of receiving substandard care.</description><subject>Health care expenditures</subject><subject>Insurance coverage</subject><subject>Medicare</subject><subject>Mortality</subject><subject>Socioeconomic factors</subject><issn>2379-4607</issn><issn>2379-4615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kF9LwzAUxYMoOOa-gE8Bwbe6m6ZJOt9k6BwM9EGfS9rc2Iz-W9IO9-3tmIggwoV7OfzOuXAIuWZwx5hS85irRSKZYAKAjcPgjEyOYnRUz39uUJdkFsIWRkYyloCYkPJVH9DT2n3SW2pdo5vC6YqWqKu-pMa7PdKyDZ3rR3U36Mr1h3u6rrvKFbp3bROobT3d62rAKNcBDfXo6nzwAWtsetq1I-kwXJELq6uAs-89Je9Pj2_L52jzslovHzZREUMCkcGEcZEyDqKQKk1A57ERMRpjcpOkObfADUJhpDQLJTHPrbBWLqBgVlur-ZTcnHI73-4GDH22bQffjC8zpiTEPI1TPlLxiSp8G4JHm3Xe1dofMgbZsdTsb6mjaX4yBf2Bv2L_d3wBX5N4Pg</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Manary, Matthew</creator><creator>Staelin, Richard</creator><creator>Boulding, William</creator><creator>Glickman, Seth W.</creator><general>SAGE Publications</general><general>The Brookings Institution</general><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>4U-</scope><scope>7XB</scope><scope>88J</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DPSOV</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>KC-</scope><scope>M2L</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>201504</creationdate><title>Payer mix &amp; financial health drive hospital quality: Implications for value-based reimbursement policies</title><author>Manary, Matthew ; Staelin, Richard ; Boulding, William ; Glickman, Seth W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2040-de413581305c67840ab2d52edddbd48b3f03de0cd66d976ebbf5ff690c1faffa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Health care expenditures</topic><topic>Insurance coverage</topic><topic>Medicare</topic><topic>Mortality</topic><topic>Socioeconomic factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manary, Matthew</creatorcontrib><creatorcontrib>Staelin, Richard</creatorcontrib><creatorcontrib>Boulding, William</creatorcontrib><creatorcontrib>Glickman, Seth W.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Politics Collection</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>ProQuest Politics Collection</collection><collection>Political Science Database</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Behavioral science &amp; policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Manary, Matthew</au><au>Staelin, Richard</au><au>Boulding, William</au><au>Glickman, Seth W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Payer mix &amp; financial health drive hospital quality: Implications for value-based reimbursement policies</atitle><jtitle>Behavioral science &amp; policy</jtitle><date>2015-04</date><risdate>2015</risdate><volume>1</volume><issue>1</issue><spage>77</spage><epage>84</epage><pages>77-84</pages><issn>2379-4607</issn><eissn>2379-4615</eissn><abstract>Documented disparities in health care quality in hospitals have been associated with patients’ race, gender, age, and insurance coverage. We used a novel data set with detailed hospital-level demographic, financial, quality-of-care, and outcome data across 265 California hospitals to examine the relationship between a hospital's financial health and its quality of care. We found that payer mix, the percentage of patients with private insurance coverage, is the key driver of a hospital's financial health. This is important because a hospital's financial health influences its quality of care and patient outcomes. Government policies that financially penalize hospitals on the basis of care quality and/or outcomes may disproportionately impair financial performance and quality investments at hospitals serving fewer privately insured patients. Such policies could exacerbate health disparities among patients at greatest risk of receiving substandard care.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><doi>10.1177/237946151500100110</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext_linktorsrc
identifier ISSN: 2379-4607
ispartof Behavioral science & policy, 2015-04, Vol.1 (1), p.77-84
issn 2379-4607
2379-4615
language eng
recordid cdi_proquest_journals_1760238283
source Sage Journals GOLD Open Access 2024
subjects Health care expenditures
Insurance coverage
Medicare
Mortality
Socioeconomic factors
title Payer mix & financial health drive hospital quality: Implications for value-based reimbursement policies
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T23%3A59%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_AFRWT&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Payer%20mix%20&%20financial%20health%20drive%20hospital%20quality:%20Implications%20for%20value-based%20reimbursement%20policies&rft.jtitle=Behavioral%20science%20&%20policy&rft.au=Manary,%20Matthew&rft.date=2015-04&rft.volume=1&rft.issue=1&rft.spage=77&rft.epage=84&rft.pages=77-84&rft.issn=2379-4607&rft.eissn=2379-4615&rft_id=info:doi/10.1177/237946151500100110&rft_dat=%3Cproquest_AFRWT%3E3933538821%3C/proquest_AFRWT%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1760238283&rft_id=info:pmid/&rft_sage_id=10.1177_237946151500100110&rfr_iscdi=true