Early impacts of the Pennsylvania Rural Health Model on potentially avoidable utilization.
| Autor: | Bourne DS; Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, United States., Roberts ET; Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, and Leonard Davis Institute of Health Economics, Philadelphia, PA 19104, United States., Sabik LM; Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, United States. |
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| Jazyk: | angličtina |
| Zdroj: | Health affairs scholar [Health Aff Sch] 2024 Jan 19; Vol. 2 (2), pp. qxae002. Date of Electronic Publication: 2024 Jan 19 (Print Publication: 2024). |
| DOI: | 10.1093/haschl/qxae002 |
| Abstrakt: | The Pennsylvania Rural Health Model (PARHM) is a novel alternative payment model for rural hospitals that aims to test whether hospital-based global budgets, coupled with delivery transformation plans, improve the quality of health care and health outcomes in rural communities. Eighteen hospitals joined PARHM in 3 cohorts between 2019 and 2021. This study assessed PARHM's impact on changes in potentially avoidable utilization (PAU)-a measure of admission rates policymakers explicitly targeted for improvement in PARHM. Using a difference-in-differences analysis and all-payer hospital discharge data for Pennsylvania hospitals from 2016 through 2022, we found no significant overall reduction in community-level PAU rates up to 4 years post-PARHM implementation, relative to changes in rural Pennsylvania communities whose hospitals did not join PARHM. However, heterogeneous treatment effects were observed across cohorts that joined PARHM in different years, and between critical access vs prospective payment system hospitals. These findings offer insight into how alternative payment models in rural health care settings may have heterogeneous impacts based on contextual factors and highlight the importance of accounting for these factors in proposed expansions of alternative payment models for rural health systems. Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials. (© The Author(s) 2024. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.) |
| Databáze: | MEDLINE |
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