The Impact of CMS Public Reports of Hospital Charge Data

项目摘要/摘要 随着美国更多地获得医疗保险，面临着高成本的现实，以及 政策制定者开始面临负担能力差距的危险，人们对价格和 价格透明的潜力，以增加竞争和减缓价格增长。在……里面 2013年5月，医疗保险和医疗补助服务中心(CMS)开始公布 约3,400家医院提供的住院和门诊服务账单最多 美国的医院。目标是增加透明度，并使更大的市场力量发挥作用 医院服务价格的急剧上涨。网上发布的数据显示， 国家、地区和一些地区对相同程序的收费差异很大 甚至在当地，引发了媒体的强烈和立即反应。但是出版的是 CMS医院收费数据对医院服务市场的影响？如果是，那是什么？ 信息流动的渠道是什么？价格透明度是一种非常新的 战略和尚不清楚谁对哪些具体信息做出了回应，以及这些信息是如何 应对措施正在影响医院服务的市场。通过这项研究，我们建议 审查合作医疗价格透明度倡议是否以及如何作为政策杠杆在 控制医院价格高增长的目标。我们建议进行一次回顾 使用定量方法进行研究，包括描述性和计量经济学分析 目的1)调查合作医疗赞助的医院收费信息对竞争的影响 住院收费和住院服务利用情况及目标2)探讨 利益相关者是最容易接受公开报告的价格信息的受众。至 针对目标1，我们将应用差异模型来检查医院 CMS数据发布后，费用发生变化。为了解决目标2，我们将使用中断时间 在CMS数据之后检验医院数量和市场份额变化的系列分析 放手。结果将为CMS提供大量信息，因为它计划未来发布这两个项目的数据 住院和门诊数据。许多国家机构目前都有价格透明的倡议。 正在进行中；其他人正在考虑立法，要求供应商向 消费者。更好地了解政府资助的报告的潜力 影响市场的医院价格信息对各州也非常有价值，因为他们 继续推进制定价格透明举措。

PROJECT SUMMARY/ABSTRACT As greater access to health insurance in the U.S. comes up against the reality of high costs, and policymakers begin to face the dangers of affordability gaps, there is rising interest in prices and in the potential for price transparency to increase competition and mitigate price growth. In May 2013, the Centers for Medicare and Medicaid Services (CMS) began publishing charges for the most frequently billed inpatient and outpatient services provided in approximately 3,400 U.S. hospitals. The goal was to increase transparency and bring greater market forces to bear on the steep growth in prices for hospital services. The online data release, which revealed dramatic differences in charges for the same procedures nationally, regionally and in some places even locally, prompted an intense and immediate media reaction. But is publication of the CMS hospital charge data impacting the market for hospital services? And if it is, what are the channels through which the information is flowing? Price transparency is a very new strategy and it unclear who is responding to what specific information and how these responses are affecting the market for hospital services. With this study, we propose to examine if and how the CMS price transparency initiative is performing as a policy lever in the goal of reining in the high growth of hospital prices. We propose to conduct a retrospective study using quantitative methods that will include both descriptive and econometric analyses to Aim 1) investigate the competitive impact of CMS-sponsored hospital charge information on inpatient charges and on utilization of inpatient services and Aim 2) to explore which stakeholders are the most receptive audiences for publicly reported price information. To address Aim 1, we will apply a difference-in-differences model to examine whether hospital charges change following the CMS data release. To address Aim 2, we will use interrupted time series analysis to examine shifts in hospital volume and market share following the CMS data release. Results will be highly informative to CMS as it plans future data releases for both inpatient and outpatient data. Many state agencies currently have price transparency initiatives underway; others are considering enacting legislation requiring providers to disclose prices to consumers. Better understanding of the potential for government-sponsored reporting of hospital price information to impact the market will also be very valuable to states as they continue to move forward with developing price transparency initiatives.