New HCFO Grants Announced

Title: Impact of Profitability on Hospital Responses to Financial Stress
Institution: University of Pennsylvania
Principal Investigator: Kevin Volpp, M.D., Ph.D.
Grant Period: 12/1/07 – 11/30/09
Paragraph Summary: The researchers would examine the impact of financial pressure on hospitals on the quality of care provided. They would test whether hospitals' responses to a change in the level of reimbursement is likely to vary by DRG-specific incentives, using the Medicare BBA as an example. They would: 1) calculate the generosity of Medicare payment by diagnoses and service lines for 1995, 2000, and 2005; 2) compare the quality of care received by patients hospitalized with conditions from more vs. less profitable service lines in 1995, 2000, and 2006; 3) test the effects of changes in reimbursement on mortality for more vs. less generously reimbursed diagnoses and service lines; and 4) test the effects of changes in reimbursement on Patient Safety Indicators (PSIs) for more vs. less generously reimbursed diagnoses and service lines. The researchers note that existing studies on the effects of financial stress on hospitals have examined acute myocardial infarctions, one profitable condition that may provide a misleading sense of the overall impacts on quality and cost/quality tradeoffs. The objective of this study is to provide policymakers with better ability to measure profitability and quality for hospital service lines (e.g., neurosurgery, cardiology, etc.), the level at which many important decisions about resource allocation are made.

Title: Waiting for Outpatient Care and Choice in Financing
Institution: Boston VA Research Institute, Inc.
Principal Investigator: Julia Prentice, Ph.D., M.S.P.H.
Grant Period: 12/1/07 – 11/30/08
Paragraph Summary: The researchers will examine how increasingly long wait times for medical appointments have resulted in individuals exiting healthcare systems with lengthy waits and paying more to access alternative systems with shorter waits. They are exploring whether these time/cost tradeoffs affect how individuals choose among healthcare financing options. Specifically, the researchers will focus on veterans who receive care through the Department of Veterans Affairs (VA) or pay more out-of-pocket to access the Medicare program. The researchers hypothesize that: (1) long waits in local VA facilities will reduce the probability that individuals will use VA healthcare and (2) individuals with greater resources, as compared to individuals with fewer resources, will be more likely to choose more expensive Medicare plans rather than wait for care in the VA. The objective of the study is to inform policymakers, who make decisions on reimbursement rates, how time/cost tradoffs affect patients’ health care financing choices.

 
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