Do Medicare and Medicaid Payer-Mix Change After the Privatization of Public Hospitals?

Author:

Ramamonjiarivelo Zo1ORCID,Weech-Maldonado Robert2,McRoy Luceta3,Epané Josué Patien4,Zengul Ferhat D.2,Hearld Larry2ORCID

Affiliation:

1. Texas State University, San Marcos, TX, USA

2. University of Alabama at Birmingham, Birmingham, AL, USA

3. Southern Adventist University, Collegedale, TN, USA

4. University of Nevada, Las Vegas, NV, USA

Abstract

This study assessed the impact of public hospitals’ privatization on payer-mix. We used a national sample of nonfederal, acute care, public hospitals in 1997 and followed them through 2013, resulting in a cohort of 492 hospitals (8,335 hospital-year observations). Privatization to for-profit (FP) status was associated with a greater increase in Medicare payer-mix (β = 0.13; p ≤ .001), compared with a smaller increase for privatization to not-for-profit (NFP) status (β = 0.02; p ≤ .05). FP privatization was associated with a greater decrease in Medicaid payer-mix (β = −0.09; p ≤ .001), compared with NFP privatization (nonsignificant). There is a larger change in payer-mix after FP privatization than after NFP privatization.

Publisher

SAGE Publications

Subject

Health Policy

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