Econ Papers Daily / 期刊论文
涡轮增压利润？医疗保健中的合同博弈与收入分配
Turbocharging Profits? Contract Gaming and Revenue Allocation in Healthcare
摘要
Firms often exploit weaknesses in government contracts to boost revenues, yet little is known about how they allocate these funds. We study how hospitals allocated $3 billion obtained from gaming a Medicare loophole. The average gaming hospital increased Medicare and total revenue by around 10 percent, implying large spillovers on other payers. Nonprofit hospitals deployed most funds toward operating costs. For-profits—driven by a large chain—deducted funds off their balance sheets, distributing them to executives and shareholders. Accordingly, we detect reductions in mortality only at nonprofits. Our results imply that the consequences of engineered windfalls vary substantially by hospital ownership. (JEL D86, H51, I11, I12, I18, L31)
中文摘要
企业常利用政府合同漏洞增加收入，但关于这些资金如何分配的研究甚少。本文研究了医院如何分配通过利用医疗保险制度漏洞获得的30亿美元。平均而言，利用漏洞的医院将医疗保险收入和总收入提高了约10%，这意味着对其他支付方产生了巨大的溢出效应。非营利性医院将大部分资金用于运营成本。营利性医院——由大型连锁医院驱动——则将资金从资产负债表中扣除，分配给高管和股东。相应地，我们仅在非营利性医院中观察到死亡率下降。研究结果表明，意外收益的后果因医院所有权性质而显著不同。（JEL D86, H51, I11, I12, I18, L31）