Medicare payment policy has stimulated important health services research on hospitals. Health services research provided the foundation for the original PPS system. Since its implementation, health services research has influenced subsequent decisions at the margin. This research has highlighted limitations in these measures--particularly measures of teaching activity and hospital policy. It is important to implement any payment system as good as possible at the outset. Once a system is in place, any change will lead to an identifiable set of winners and losers, and the more powerful the losers, the less likely the change. Health services research will lead to minor changes. However, it will take political will to make major changes.
This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.
Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/research-integrity.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.