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American Economic Review Vol. 111 No. 4 2021

Impacts of Performance Pay for Hospitals: The Readmissions Reduction Program

Atul Gupta

The Wharton School and Leonard Davis Institute, University of Pennsylvania (email: )

Abstract

US policy increasingly ties payments for providers to performance on quality measures, though little empirical evidence guides the design of such incentives. I deploy administrative data to study a large federal program that penalizes hospitals with high readmissions rates. Using policy-driven variation in the penalty incentive across hospitals for identification, I find that hospital responses to the penalty account for two-thirds of the observed decrease in readmissions over this period, as well as a decrease in heart attack mortality. Quality improvement accounts for about one-half of the decrease in readmissions; the remainder is explained by selective admission of returning patients.

DOI
10.1257/aer.20171825
Volume
111
Issue
4
Pages
1241-1283
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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