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Establishing a Fair Playing Field for Payment by Results

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Author Info
Anne Mason (Centre for Health Economics, University of York, UK.)
Marisa Miraldo (Centre for Health Economics, University of York, UK.)
Luigi Siciliani (Centre for Health Economics, University of York, UK.)
Peter Sivey (Centre for Health Economics, University of York, UK.)
Andrew Street (Centre for Health Economics, University of York, UK.)

Additional information is available for the following registered author(s):

Abstract

The English government has encouraged private providers – known as Independent Sector Treatment Centres (ISTCs) – to treat publicly funded (NHS) patients. Providers are paid a fixed price per patient treated, adjusted to reflect geographical differences in input costs. But there may be other legitimate cost variations between providers. This report considers the regulatory and production-process constraints that could cause public and private providers costs to differ. Most of these exogenous cost differentials can be rectified by adjustments to the regulatory system or to the payment method. We find evidence that ISTCs are treating different types of patients than NHS hospitals. If these differences drive costs, payments for treatment might need to be differentiated by setting.

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File URL: http://www.york.ac.uk/inst/che/pdf/rp39.pdf
File Format: application/pdf
File Function: First version, 2008
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Publisher Info
Paper provided by Centre for Health Economics, University of York in its series Working Papers with number 039cherp.

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Length: 87 pages
Date of creation: Jul 2008
Date of revision:
Handle: RePEc:chy:respap:39cherp

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Martin Feldstein, 2005. "Rethinking Social Insurance," American Economic Review, American Economic Association, vol. 95(1), pages 1-24, March. [Downloadable!]
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  2. Vassilis H. Aletras, 1999. "A comparison of hospital scale effects in short-run and long-run cost functions," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 521-530.
  3. Martin Feldstein, 1995. "Would Privatizing Social Security Raise Economic Welfare?," NBER Working Papers 5281, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October. [Downloadable!] (restricted)
  5. Ellis, Randall P. & Vidal-Fern?Ndez, Marian, 2007. "Activity-based payments and reforms of the English hospital payment system," Health Economics, Policy and Law, Cambridge University Press, vol. 2(04), pages 435-444, October. [Downloadable!]
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