Description:

Yoshi Katayama (Northwestern): "Readmission Penalty under Nonlinear Payment Schedules"

Abstract: I examine how hospitals respond to financial incentives. In Japan, the per diem payment is designed to decrease as the length of stay increases to incentivize early discharge. However, under these nonlinear payment schedules, hospitals can increase reimbursements with repeated discharges and readmissions. Using administrative claims data, I study hospital responses to a national policy that penalizes immediate post-discharge readmissions to limit repeated admissions. Exploiting variations created by the program introduction, I find that hospitals delay readmissions to avoid the penalty for elective patients. In contrast, for non-elective patients, readmissions immediately after discharge decrease due to selective readmission. Moreover, there are no detectable effects on health outcomes. These findings suggest that hospital responses to financial incentives depend on patient health status.