Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data

This study investigated whether the type of hospital in which a Medicare beneficiary is admitted for hip fracture, stroke, coronary heart disease, or congestive heart failure matters in terms of amount and timing of Medicare payments and survival. In total, government hospitals were the least expensive for Medicare, with major teaching hospitals being most expensive within six months of admission after the index event. Survival was best in major teaching hospitals. When considering payments subsequent to those for the initial hospitalization, Medicare spent more for patients admitted to for-profit hospitals than for those admitted to other nonteaching facilities, but had similar outcomes measured by survival. Payments on behalf of patients treated in for-profit hospitals were higher for Medicare Part B and home health, especially during the first two months following discharge from the initial hospital. Results of our research suggest that Medicare has a definite financial interest in where Medicare beneficiaries are admitted for their hospital care.