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- W2003707077 abstract "This study investigates the impact of the 1992 Medicare capital prospective payment regulation on hospital financing decisions, using a sample of California hospitals. The regulation, which changed reimbursement for hospital inpatient capital costs from a cost-based to a fixed fee per patient system, eliminated previous regulatory incentives to use debt and eliminated implicit guarantees of hospital debt service. Overall, I find that hospitals decrease the use of long-term debt after implementation of the regulation and that Medicare share of business and the decrease in capital expenditures are significant in explaining this decrease. In addition, I find that the decline is substantially greater for high-cost than low-cost hospitals. Multivariate analyses suggest that some low-cost (high-cost) hospitals increase (decrease) debt, after controlling for other factors. For low-cost hospitals, the relation between Medicare share of business and debt becomes more negative after the regulatory change, suggesting that low-cost hospitals with greater dependence on Medicare business are more likely to decrease debt. For high-cost hospitals, the relation between capital expenditures and debt becomes less positive after the regulatory change, suggesting that a decrease in capital expenditures affects the need for debt financing. Combined with results from prior research that suggest that low-cost (high-cost) hospitals increase (decrease) capital expenditures following the regulation, results are consistent with changes in capital expenditures leading to differential needs for financing and with hospitals adjusting financing practices in response to the expected increase (decrease) in capital cost reimbursement." @default.
- W2003707077 created "2016-06-24" @default.
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- W2003707077 date "2003-03-01" @default.
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- W2003707077 title "The effect of Medicare capital prospective payment regulation: additional evidence from hospital financing decisions" @default.
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- W2003707077 doi "https://doi.org/10.1016/s0278-4254(03)00006-1" @default.
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