Fuqua’s Dean Bill Boulding, Professor Richard Staelin, alumni Matthew Manary and Seth Glickman studied the impact of a hospital’s financial health on quality of care. Currently, the US government penalizes lower-performing hospitals with lower reimbursements, which in turn could lead to a downward spiral of service quality. This is particularly worrying because many of these under-performing hospitals serve high uninsured and under-insured patient populations. They examine this issue via a framework where they establish the connection between a hospital’s demographics, its patient insurance coverage mix, and its financial health. Next they show the hospital’s financial health strongly affects its capital investment, clinical adherence to guidelines, and patient experience, all of which in turn affect patient outcomes. They argue that hospitals treating higher percentages of minority patients also report worse patient experiences, lower clinical adherence, and worse health outcomes due in large part to poorer insurance coverage and poorer financial health. They suggest that one approach to addressing this problem is to incorporate patient insurance coverage profiles into the value-based reimbursement formula.
Read more in “Payer mix & financial health drive hospital quality: Implications for value-based reimbursement policies” Behavioral Science & Policy
Manary, M., Staelin, R., Boulding, W., & Glickman, S. W. (2015). Payer mix & financial health drive hospital quality: Implications for value-based reimbursement policies. Behavioral Science & Policy, 1(1), pp. 77–84.