Academic medical centers (AMCs)

, 88

Accessibility

, 105–106

Accountability

, 190

Acute Care Episode (ACE)

, 10

Acute myocardial infraction (AMI)

, 147, 149–150

Adverse selection

, 195–196

Affordable Care Act (ACA)

, 11, 56, 62, 81, 112

consumer decision-support tools

, 125

penalties, subsidies, and health plan choice

, 124–125

Agency for Healthcare Research and Quality (AHRQ)

, 130, 164–166

Agency theory

, 2–3

Agents

, 2–3

Alternative Quality Contract

, 80

American Hospital Association (AHA)

, 47, 56, 65, 102

Annual Survey

, 65–67

American Life Panel (ALP)

, 118–119

descriptive statistics of

, 120, 122–123

FL questions in

, 119

Analyses of variance (ANOVA)

, 49–51

Ardent Health Services Corporation

, 10

Area Health Resources Files (AHRF)

, 47

Balance billing restrictions

, 199

Baptist Health System (San Antonio, TX)

, 10

Binary variables

, 34

Blue Care Network HMO

, 5

BPCI Advanced Model

, 13

Breusch–Pagan test for heteroskedasticity

, 32

Bundled payment models

choice implications

, 18–20

early CMS adoption

, 5–6

early learning dissemination and slow progress (1997–2005)

, 6–7

early payer models

, 3–4

pioneering innovations (1984–1985)

, 4

private sector adoption and early CMS interest (1986–1989)

, 4–5

reemergence and wide adoption of bundled payments (2005–present)

, 7–13

Bundled payment programs

clinical levers to increase episode efficiency

, 15–16

establishing markets for

, 16–18

factors in determining target price

, 15

implications of bundled payment model choice

, 18–20

importance of measuring impact

, 16

through lens of agency theory

, 2–3

market catalysts for

, 14–15

policy recommendations

, 13–20

prerequisite standard definitions

, 13–14

Bundled Payments for Care Improvement initiative (BPCI initiative)

, 11–13

Business imperative

, 195

California CABG Outcomes Reporting Program (CCORP)

, 179

Capital structure, tradeoff theory of

, 62–63

Captcha functionalities

, 110

CardioVascular Care Providers, Inc. (CVCP)

, 4

Centers for Medicare and Medicaid Services (CMS)

, 4–5, 100–101, 109, 199

early CMS adoption

, 5–6

Central line bloodstream infection (CLABSI)

, 148

Charge and pricing data compiling issues

, 110

Charge description master (CDM)

, 105–106

Chargemaster transparency

compliance

, 105–106

regulation

, 109–111

Chen’s review

, 133

Chi-square test

, 104

Clinical levers to increase episode efficiency

, 15–16

Clinical outcomes

, 178

Cochrane Library

, 136

Coding and analysis

, 103–104

Communities

, 45–46

stakeholder attributes

, 46

Community orientation (CO)

, 44–47, 52, 54–55

fixed-effects negative binomial regression

, 52

Compensable events

, 187–188

Compensation

equitable access to

, 194–195

full coverage of

, 185–186

translates improved outcomes to lower premia

, 189–190

uncertain

, 184–185

Competitive markets

, 88–89

Compliance

with and utility of current chargemaster transparency regulation

, 109–111

chargemaster transparency

, 105–106

Comprehensive Care for Joint Replacement Model (CJR Model)

, 13

Consumer

engagement

, 108, 110–111

financial literacy

, 118

welfare in health care

, 87–88

Contingency table for webpage vs. sentiment

, 108

Control variables

, 48–49, 168

Copayments

, 116–117

Coronary Artery Bypass Graft (CABG). See also Public reports of CABG outcomes

, 4–6, 138–147, 150

Cost

containment

, 76–78

minimization of outcomes improvement

, 189

Council of Teaching Hospitals and Health Systems (COTH)

, 48–49

Critical Access Hospital (CAH)

, 27, 28–29, 34–35, 37–38, 47

“Crossing the Quality Chasm”

, 130

Data

collection

, 183

privatization of public hospitals

, 47

transparency

, 138

Debt

, 64

Deductibles

, 116–117

Defensive medicine

, 186

Definitive stakeholders

, 45, 65

Dependent variable

, 48, 67

in profitability analysis

, 33

Descriptive statistics

, 33, 104–105

of ALP

, 120, 122–123

Deterrence, imperfect

, 186

Diagnosis-related group (DRG)

, 5–6, 31–32, 100

Doctors Hospital of Dallas (Dallas/Fort Worth, TX)

, 6

Dormant stakeholders

, 45–47

Early learning dissemination and slow progress (1997–2005)

, 6–7

Early payer models

, 3–4

Earned Income Tax Credit

, 116

Easy-to-understand quality metric

, 190

Economic problem in price transparency

, 81–82

Economics of price-cutting

, 82–84

Employee safety climate

, 159–160

EndNote Reference Management Tool

, 136

Environmental services (EVS)

, 158–159, 163, 164, 171

Episode-based bundled payment programs

, 1

Equitable treatment quality

, 198–199

Exclusion/inclusion criteria

, 136, 137

Exorbitant administrative cost

, 184

Expectant stakeholders

, 45–46

Federal Office of Rural Health Policy

, 32

Federal poverty level (FPL)

, 116, 123

FL by income in percentage of

, 122

Federal Trade Commission

, 82

File accessibility issues

, 110

File formatting issues

, 110

Financial literacy (FL)

, 118

characteristics of individuals with high financial literacy

, 123

by income in percentage of FPL

, 122

index of

, 119

multivariable regression explaining

, 124

multivariable regression of predictors of

, 123

questions in ALP

, 119

Fixed-effects negative binomial regression

, 52, 53

Food & Nutrition (F&N)

, 163–164, 171

Full coverage of compensation

, 185–186

Full-text review

, 136–137

“FY 2019 LTCH PPS Final Rule” regulation

, 101

Gag clauses

, 87

Geisinger Health System

, 7

Generic Pharmaceutical Association (GPhA)

, 91

Google Scholar

, 132–133

Government Accountability Office (GAO)

, 26, 79

Government-owned hospitals. See Public hospitals

Group purchasing organizations (GPOs)

, 83

Hahnemann Hospital

, 26

Health and Human Services

, 4–5

Health care

, 130

Health Care and Education Reconciliation Act

, 10

Health Care Financing Administration (HCFA)

, 5–6

Health Care Incentive Improvement Newsletter

, 81

Health Care Incentives Improvement Institute (HCI3)

, 8

Health Care Payment Learning and Action Network

, 14–15

Health care product markets

, 88–89

competitive markets

, 88–89

inevitable monopoly

, 89

oligopoly, unstable and stable

, 89

Health insurance

, 116

analyses

, 120–122

characteristics of individuals with high FL

, 123

characteristics of respondents

, 121

choices

, 118, 125

descriptive statistics

, 122–123

descriptive statistics of ALP sample

, 120

differences by income group

, 123

discussion

, 124–126

employer-sponsored

, 117

exchanges

, 117

FL by income in percentage of FPL

, 122

FL questions in ALP

, 119

index of FL

, 119

insurance status and income

, 119–120

limitations

, 125–126

literacy

, 118

multivariable regression explaining financial literacy

, 124

multivariable regression of predictors of financial literacy

, 123

study sample

, 118–119

Health Maintenance Organization (HMO)

, 5

Health plan choice

, 116–117

Health service area (HSA)

, 49

Health status

, 166

Health care quality

, 131

Healthcare Cost Report Information System

, 32

Heart failure (HF)

, 147–148

Herfindahl–Hirschman Index (HHI)

, 34, 49

Hidden price discrimination

, 84

“High leverage” hospitals

, 67

High-deductible health plans (HDHPs)

, 77, 80, 91–94

High-risk

patients

, 198

physicians

, 197–198

Highly salient stakeholders. See Definitive stakeholders

Hospital Compare

, 111

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

, 102–103

Hospital Outpatient Prospective Payment System (OPPS)

, 100

Hospital quality

, 133, 135–136, 138, 149, 152

Hospital Readmission Reduction program

, 66

Hospitals

, 26

selection

, 102–103

system

, 64–67

Impact measurement

, 16

Improved provider-patient matching

, 193

Incentives for patients to invest in risk reduction

, 193–194

Incidence rate ratios (IRRs)

, 50

Independent variable

, 48, 67

Individual safety perception

, 166

Inevitable monopoly

, 89

Innovations (1984–1985)

, 4

Insurance against adverse outcomes

, 186–187

Internal consistency alphas

, 168

Joint tests

, 50

Kaiser Permanente

, 103

Knowledge gaps

, 131

Legitimacy

, 45

Leverage

barriers to optimal

, 63–64

difference-in-difference estimates of changes in

, 70

independent NFP hospital leverage

, 68

Licensing requirements

, 199

Local Area Unemployment Statistics (LAUS)

, 47

Lovelace Health System (Albuquerque, NM)

, 10

“Low-leverage” hospitals

, 67

Low-risk patients

, 180–181

Low-use equilibrium

, 182–183

Low-volume providers

, 196–197

Malpractice liability

, 192

quality assurance through medical

, 183–186

Management problem in price transparency

, 82

Market

catalysts for bundled payment programs

, 14–15

competition

, 79, 83–84, 89, 93

establishment for bundled payment programs

, 16–18

Massachusetts Data Analysis Center (Mass-DAC)

, 179

“Mechanical Turks”

, 112–113

Medicaid

, 26–27, 85, 111, 116

expansion

, 27–29, 30

programs

, 27–29

Medical care attributes

, 178

Medical Eye Associates and Cataract Eye Center (Cleveland, OH)

, 6

Medicare

, 1–2, 26–27, 30, 85, 111

fee-for service

, 7–8

programs

, 28, 37

Value-Based Purchasing program

, 66

Medicare Advantage penetration

, 49

Medicare Cost Reports. See Healthcare Cost Report Information System

Medicare Dependent Hospital (MDH)

, 27–29, 37

estimated coefficients

, 36–37

Medicare Participating Heart Bypass Center Demonstration

, 5–6

Medicare Payment Advisory Commission (MedPAC)

, 8–11

Medicare Prospective Payment System (PPS)

, 27, 37–38

Medicare Severity Diagnosis-Related Groups (MS-DRGs)

, 9–10

Medicare Trust Fund

, 38–39

Methodist Hospital (Indianapolis, IN)

, 6

Minnesota Community Measurement Transparency Collaborative

, 78

Moderately salient stakeholders. See Expectant stakeholders

Monopoly

inevitable

, 89

price discrimination under

, 86

Moral hazard

, 196

Mortality relationship with transparency

, 139–141

Multiple principal–agent relationships

, 2

Multivariable regression

explaining FL

, 124

of predictors of FL

, 123

National Center for Health Statistics (NCHS)

, 164–166

National Commission on Physician Payment Reform

, 3

National Health and Nutrition Examination Surveys

, 164–166

National Institute for Occupational Safety and Health (NIOSH)

, 160–161

Organization of Work on Occupational Safety and Health framework

, 161

National Nursing Home Survey

, 164–166

Negligence rule

, 183–184

New Jersey Department of Health and Senior Services Registry (NJDHSS)

, 179

New York Cardiac Surgery Reporting System (NY-CSRS)

, 179

NIOSH occupational safety and health framework

, 160–164, 170

support service workers

, 163–164

Nonoperating income

, 34–35

Not-for-profit hospitals (NFP hospitals)

, 6, 44, 54, 62, 65, 50–52

analysis

, 66

data and sample

, 65–66

difference-in-difference estimates of changes in leverage

, 70

discussion

, 71–72

independent NFP hospital leverage

, 68

kernel density plot of propensity scores

, 69

measurement

, 67

preacquisition hospital characteristics

, 68

results

, 68–70

Occupancy rate

, 31, 31

Occupational injury

, 158

data analysis

, 168

descriptive statistics, correlations, and scale reliabilities

, 167

discussion

, 170–171

limitations

, 171

measurement

, 164–168

NIOSH occupational safety and health framework

, 160–164

relationship of safety and unit leadership

, 169

results

, 168–169

sample demographics

, 164, 165

Oligopoly, unstable and stable

, 89

Oncology Care Model (OCM)

, 13

Optimal coverage amount

, 192

Optimal investment in outcomes improvement

, 188–189

Optimal risk sharing

, 191–192

Organizational safety leadership

, 166

Out-of-pocket limits

, 116–117

Outcome warranties. See also Public reports of CABG outcomes; Quality assurance through medical malpractice liability

, 178

accountability

, 190

adverse selection

, 195–196

balance billing restrictions

, 199

business imperative

, 195

compensable events

, 187–188

competition translates improved outcomes to lower premia

, 189–190

considerations for regulators

, 199

easy-to-understand quality metric

, 190

equitable access to compensation

, 194–195

equitable treatment quality

, 198–199

high-risk patients

, 198

high-risk physicians

, 197–198

incentives for patients to invest in risk reduction

, 193–194

insurance against adverse outcomes

, 186–187

licensing requirements

, 199

low-volume providers

, 196–197

minimization of cost of outcomes improvement

, 189

moral hazard

, 196

optimal coverage amount

, 192

optimal investment in outcomes improvement

, 188–189

optimal risk sharing

, 191–192

provider specialization and improved provider-patient matching

, 193

quality revelation through PRCs

, 179–180

risk selection

, 194

third-party verification

, 196

trade-off of mortality risk reductions

, 193

Outcomes improvement

competition translates improved outcomes to lower premia

, 189–190

cost minimization of

, 189

optimal investment in

, 188–189

Participating Centers of Excellence Demonstration for Orthopedic and Cardiovascular Services

, 7

Patient Protection and Affordable Care Act (PPACA)

, 10, 27, 44–45, 112, 116

Payments for care

, 1

Pennsylvania Health Care Cost Containment Council (PHC4)

, 179

Percutaneous coronary intervention (PCI)

, 147, 149–150

Percutaneous transluminal coronary angioplasty (PTCA)

, 181

Personal or institutional practices

negative effect on

, 147

no effect on

, 147

positive effect on

, 138–147

Physical hazards

, 162

Physician–hospital organizations (PHOs)

, 9–10

Pneumonia (PN)

, 147–148

Policymakers

, 150

Poor matching of patients to Providers and Procedures

, 181–182

Post-acute care settings (PAC settings)

, 9

Power

, 45

Preferred reporting items for systematic reviews and meta-analyses (PRISMA)

, 135

Preoperative expectation of discharge home

, 18–19

Prerequisite standard definitions

, 13–14

Price discrimination

, 85–87

hidden

, 84

hospitals in

, 101

under monopoly or stable cartels

, 86

under unstable oligopoly

, 86–87

Price transparency. See also Transparency

, 76, 100

challenges facing pricing transparency solution

, 111–112

chargemaster transparency compliance and accessibility

, 105–106

classifying health care product markets

, 88–89

coding and analysis

, 103–104

compliance with and utility of current chargemaster transparency regulation

, 109–111

consumer welfare in health care

, 87–88

contingency table for webpage vs. sentiment

, 108

cost containment

, 76–78

descriptive statistics

, 104–105

differences in real markets with real patients

, 85

economic problem

, 81–82

economics of price-cutting

, 82–84

harms

, 92–93

helps

, 91–92

hidden price discrimination

, 84

hospital selection

, 102–103

interpretation of results

, 108–109

limitations and future directions

, 113

limits on impact

, 80

management problem

, 82

policy and management

, 93–94

review of literature

, 78–80

selected illustrative quotes

, 107

sentiment analysis

, 106–107, 111

sentiment of homepage vs. price transparency page

, 107–108

US hospital characteristics

, 105

webpage selection

, 103

Price-cutting, economics of

, 82–84

Pricing transparency webpage identification

, 109

Primary care markets

, 89

Private for-profit hospitals (FP hospitals)

, 44, 46–47, 50–52, 54

fixed-effects negative binomial regression

, 53

Private sector adoption and early CMS interest (1986–1989)

, 4–5

Privatization of public hospitals

, 44

analysis

, 49–50

conceptual framework and hypotheses

, 45–47

cross-tabulations and analysis of variance

, 51

data

, 47

directions for future research

, 56

discussion

, 54–57

fixed-effects negative binomial regression

, 52, 53

limitations of study

, 56

managerial, policy, and research implications

, 56–57

results

, 50–54

variables

, 48–49

Producers

, 83

Profit

, 27

model

, 30–32

Profitability of rural hospitals

conceptual framework

, 27–30

descriptive statistics

, 33

discussion

, 37–40

mean values

, 35

Medicare programs targeted for rural hospitals

, 28

methods

, 32–34

ordinary least squares regression estimates, operating margin, and total margin

, 36

policy implications

, 39–40

profit model

, 30–32

results

, 34–37

Program evaluation

, 16

PROMETHEUS program

, 8–9

ProvenCare

, 7

Provider report cards (PRCs)

, 179, 182

quality revelation through

, 179–180

Provider(s)

, 83

factors

, 15

facts

, 182

specialization

, 193

Psychological stressors

, 162

Public health agencies

, 150

Public Health Service Act

, 101

Public hospitals

, 44

Public release

, 130–133, 138–147, 149–150

Public reporting

impact

, 138–147

of quality measures

, 130–131

Public reports of CABG outcomes. See also Coronary Artery Bypass Graft (CABG); Outcome warranties

, 179

costly data collection

, 183

low-use equilibrium

, 182–183

no guarantee of future performance

, 179–180

poor matching of patients to providers and procedures

, 181–182

risk selection

, 180–183

upcoding

, 181

PubMed

, 29, 132–133, 136

Quality assurance through medical malpractice liability. See also Outcome warranties

, 183–186

defensive medicine

, 186

exorbitant administrative cost

, 184

full coverage

, 185–186

imperfect deterrence

, 186

negligence rule

, 183–184

uncertain compensation

, 184–185

Quality of care

, 130

RAND Corporation

, 7–9

Rate of injury

, 166

Reemergence of bundled payments (2005–Present)

, 7–13

Regulators

, 199

Request for proposals (RFP)

, 9–10

Research questions (RQ)

, 131–132

Risk selection

, 180–183, 194

Risk-adjusted mortality rates (RAMRs)

, 181–182

Robert Wood Johnson Foundation (RWJF)

, 8

Roux-en-Y gastric bypass (RYGB) surgery

, 188, 193

Rural Referral Center (RRC)

, 27–29, 34–35, 37–38

estimated coefficients

, 36–37

Rural-Urban Commuting Area (RUCA)

, 32

Safety and health services and programs

, 163

Saint Joseph’s Hospital (Atlanta, GA)

, 6

Sample means

, 168

Scopus

, 136

Search strategy

, 135–136

Searched, databases

, 136

Searchers

, 78

Sellers

, 86–87

Sentiment

contingency table for

, 108

of homepage vs. price transparency page

, 107–108

Sentiment analysis

, 101, 106–107

and effect on consumer behavior

, 111

Severity-of-illness (SOI)

, 88

“Shoppable” services

, 77, 100

“Silver bullet” solutions

, 80

Society of General Internal Medicine

, 3

Sole Community Hospital (SCH)

, 27–29, 37

estimated coefficients

, 36–37

Southwestern Eye Center (Phoenix, AZ)

, 6

St. Joseph Mercy Hospital (Ann Arbor, MI)

, 6

St. Luke’s Episcopal Hospital (Houston, TX)

, 6

St. Vincent’s Hospital (Portland, OR)

, 6

Stable cartels, price discrimination under

, 86

Stable oligopoly

, 89

Standard deviations

, 168

Strategic responses by competitors

, 82

“Structure, process, outcome” model

, 78

Supervisor safety leadership

, 166

Supervisor support

, 166

Support service workers

, 163–164

Surveys on Patient Safety Culture™ (SOPS™) Hospital Survey leadership

, 164–166, 171

System membership

, 31, 39–40

benefits

, 64–65

Systematic review on transparency

, 131–136, 149–150, 152

Target price

, 15

Tax-exempt debt

, 62–63

Teaching hospitals

, 31, 34

Tenet Corporation, Exempla Saint Joseph Hospital (Denver, CO)

, 10

Texas Heart Institute (THI)

, 4–5

The Ohio State University (Columbus, OH)

, 6

Third-party insurers

, 197

Third-party verification

, 196

Trade-off of mortality risk reductions

, 193

Tradeoff theory of capital structure

, 62–63

Transparency. See also Price transparency

, 103–104, 130–131

conceptual framework

, 131–132

data transparency

, 138

databases searched

, 136

discussion and recommendations

, 149–151

effect on quality and type of quality measure

, 147–148

exclusion/inclusion criteria

, 136, 137

full-text review

, 136–137

future recommendations

, 151–152

new contribution

, 133

previous studies

, 132–134

public reporting impact

, 138–147

of quality-of-care data

, 131

relationship with mortality

, 139–141

relationship with other quality measures

, 142–146

search strategy

, 135–136

Twenty-one care episodes

, 8

U.S. Institute of Medicine (IOM)

, 130

Uncompensated care

, 27

Unemployment

, 34

Unit safety grade

, 166

United States Department of Health and Human Services (USDHHS)

, 1–2, 164–166

University Hospital (Boston, MA)

, 6

Unstable oligopoly

, 89

price discrimination under

, 86–87

Upcoding

, 181

“Urban” markets

, 76

Urgency

, 45

“Value-based purchasing” initiatives

, 149

Variables

, 35–36

control

, 48–49

dependent

, 48

fixed-effects negative binomial regression

, 53

independent

, 48

Variance inflation factor (VIF)

, 168–169

Web of Science

, 132–133, 136

Webpage

contingency table for

, 108

as PDF

, 119

selection

, 103

Wide adoption of bundled payments (2005–Present)

, 7–13

Work injury

, 170

Work unit culture

, 166

Workplace violence

, 158–159

Workplace-related injury

, 158

Zero-order correlations

, 168