Payment Segment Differences in Hospital and Physician Charges for Inpatient and Emergency Room Procedures: Cost Shifting?

Abstract

A study of hospital facility and physician charges relative to payments, as affected by source of payment is provided. Charges relative to payment source are studied for both emergency room visits and inpatient hospital stays using the Medical Expenditure Panel Survey for 2003. We present evidence that hospitals are more flexible when billing inpatient stays than emergency room visits, where flexibility is measured in terms of charges relative to expected payments. There was little difference, however, between physician charges relative to payment for inpatient stays and emergency room visits. Finally, we found that ethnicity may have an effect on hospitals' expected payments.

KEYWORDS:

• emergency
• fees
• hospital
• inpatient
• payments
• physician
• pricing

This article was partially supported by a grant from the Auburn University at Montgomery Research Grant-in-Aid Program

Notes

Note. See appendix for variable definitions.

In performing these tests we dropped 180 emergency room visit outliers and approximately 5 inpatient stay outliers.