Impact of State Hospital Prospective Reimbursement Programs on Hospital Capital Formation, Competition and Industrial Structure: An Evaluation

摘要

The report discusses the effects prospective payment programs have had on hospital investment and competition during the 1970's. Capital formation incentives of nine major state programs are reviewed, models of investment under regulation developed, and extensive descriptive and econometric analysis presented on each program. State-year investment trends are shown by hospital ownership, size, and teaching status. Medicare Cost Report balance sheets are the principal data source (2,000 hospitals, 10 years). Closure and merger rates are also analyzed along with beds per capita. A quasi-experimental design is specified, with controls for confounding variables. Econometric results show limited effects on investment, no aging of assets, significant bed reductions in New York, and higher closure rates in Massachusetts, New York, and New Jersey.