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At least 775 records · Page 43Linked to original sources
PubMed1987

Investing in the wrong future for hospitals.

The process of offering hospital debt in public markets is strongly influenced by the feasibility study. The inaccuracy of such studies may produce substantial overinvestment in hospital capital.

Capital Financing↗
PubMed1990

Hospital market share: the declining share of small players in the market.

Analysis of a set of isolated hospital markets reveals that low-market-share hospitals have experienced a consistent decline in their market share for the last five years. The challenges presented by such a decline in market share are compounded by the overall decline in the total market (in terms of number of hospital discharges) for the markets studied. It is suggested that significant strategy changes may be required if low-market-share hospitals are to survive.

Catchment Area, Health↗
PubMed1990

Contracts between hospitals and health maintenance organizations.

This article describes the contractual relations that are emerging between health maintenance organizations (HMOs) and hospitals. Six HMOs in four large metropolitan areas provided information on 102 hospital contracts. The authors found that the HMOs are becoming more aggressive in placing hospitals in competition with each other for HMO patients. Staff and network HMOs are able to obtain a higher concentration of patients and substantially larger discounts for inpatient services than are individual practice association (IPA) plans in this study.

Competitive Bidding↗
PubMed1990

An incentive program to increase revenue in a public hospital.

Using financial reward systems to enhance revenue generation or promote cost savings has been more difficult in public than in private hospitals. The program at the Los Angeles County-University of Southern California Medical Center has demonstrated, however, that it can be done.

Cost Control↗
PubMed1989

Joint ventures in health care.

To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for-profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability.

Financial Management↗
PubMed1985

Uncompensated medical services provided by physicians and hospitals.

This article examines the magnitude of uncompensated medical services provided by physicians and hospitals in 1982 as well as variations in uncompensated care among different types of physicians and hospitals. The data, which are from surveys conducted by the American Medical Association and the American Hospital Association, indicate that both physicians and hospitals provide significant amounts of uncompensated medical care. Although the distribution of uncompensated care among different types of physicians tends to be reasonably even, in most cases, the bulk of uncompensated care delivered by hospitals is delivered by public hospitals, with private hospitals (both voluntary and for-profit) delivering relatively less uncompensated care. The implications of changes in the economic environment of medicine for uncompensated medical care are also discussed.

Charities↗
PubMed1986

A multivariate approach for classifying hospitals and computing blended payment rates.

Prospective payment for inpatient hospital care is based on the ideal that hospitals that produce similar outputs, as measured by the types of cases the hospital treats, should be paid similar prices. However, similar output is a multidimensional concept. Thus operationalization of this ideal will ultimately require a more complex framework for determining hospital payment rates than currently employed at either the federal or state level. This article illustrates a multidimensional approach to achieve this objective. This technique, called Grade of Membership, is used to generate a unique type of hospital group and to characterize individual hospitals in terms of their degree of similarity to these groups. In addition, a new concept of grouping is described, a variable set based on hospitals' internal cost structure is developed and used, and ordinary least squares regression is employed to compute prices for these groups. With the use of simulation analysis, these groups are compared with more conventional groups.

Costs and Cost Analysis↗
PubMed1987

Short-term responses of hospitals to the DRG prospective pricing mechanism in New Jersey.

Short-term responses of hospitals to the New Jersey prospective payment system, which uses Diagnosis Related Groups (DRGs) to establish rates of compensation for all payers, were examined in this study. The sample consisted of 84 New Jersey hospitals that were subject to prospective payment and a comparison group of 76 hospitals. Hospitals comprising the comparison group located in eastern Pennsylvania, were reimbursed retrospectively. Regression equations, which included independent variables to control for market supply and demand conditions, were estimated for the cost per admission, cost per day, length of stay; and cases treated. The results indicate that increases in the cost per admission and cost per day were lower (P less than 0.05) in hospitals subject to the all payer DRG system than in those institutions that were reimbursed retrospectively. In addition, the results suggest that most of the cost savings attributed to the New Jersey DRG system are due to a reduction in the average length of stay. The paper concludes with policy implications.

Cost Allocation↗
PubMed1990

Financial leases in the hospital industry. An analysis of California hospitals.

Using California hospital data, this study examined the extent to which capital leases displace debt in the hospital industry. Moreover, it analyzed how hospital and financial variables affect utilization of lease financing. In contrast to the theoretic belief that lease financing displaces debt financing, the results showed a greater use of debt with leases. The study also found smaller, free-standing facilities with a greater investment in plant and equipment employed the lease option.

California↗