The Impact of CMS Public Reports of Hospital Charge Data

项目总结/摘要 随着美国医疗保险的普及，面对高成本的现实， 政策制定者开始面临负担能力差距的危险，人们对价格的兴趣越来越大， 价格透明度的潜力，以增加竞争和减缓价格增长。在 2013年5月，医疗保险和医疗补助服务中心（CMS）开始公布 在大约3400个国家提供的住院和门诊服务中， 美国医院的目标是增加透明度，并使更大的市场力量发挥作用。 医院服务价格的急剧上涨。在线发布的数据显示， 在国家、区域和一些国家， 甚至在当地的地方，引起了强烈和立即的媒体反应。但是， CMS医院收费数据影响医院服务市场？如果是， 信息流动的渠道价格透明度是一个非常新的 战略，目前还不清楚谁是回应什么具体信息，以及如何这些 反应正在影响医院服务市场。通过这项研究，我们建议 检查CMS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CMS赞助的医院收费信息对竞争的影响， 住院费用和住院服务利用的影响，目的2）探讨 利益攸关方是公开报告的价格信息最容易接受的受众。到 解决目标1，我们将应用差异中的差异模型来检查医院是否 费用随着CMS数据的发布而变化。为了实现目标2，我们将使用中断时间 系列分析，以检查CMS数据后医院数量和市场份额的变化 release.结果将是高度翔实的CMS，因为它计划未来的数据发布， 住院病人和门诊病人数据。许多国家机构目前都有价格透明度举措 正在进行中;其他国家正在考虑制定立法，要求供应商披露价格， 消费者更好地了解政府赞助的报告 医院价格信息对市场的影响也将是非常有价值的国家，因为他们 继续推进制定价格透明度举措。

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.