Prospective Payment System Evaluation Studies: Trends in Capital Costs under Prospective Reimbursement

摘要

After the implementation of the Prospective Payment System (PPS), capital was one of the few areas of hospital costs reimbursed by Medicare on a cost basis. Although the capital reimbursement methodology was not changed, PPS may have affected capital costs. The report examines the capital costs of hospitals during the first years of PPS to describe any such effects. The study used data primarily from Medicare Cost Reports (MCRs) in the four Medicare payment periods TEFRA (FY1983) through PPS 3 (FY1986). The file included all non-exempt, nonfederal, short-term, acute-care hospitals (in non-waivered states) for which an MCR was received. Relative to the universe of hospitals, the 3,795 analyzed hospitals under-represented large urban hospitals, major teaching hospitals, and proprietary hospitals. Therefore, capital costs were analyzed by controlling for hospital characteristics. Seven types of capital costs were analyzed as: (1) a dollar level, (2) as a percent of inpatient operating expenses, and (3) per hospital discharge.