Gerald F. Kominski

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Medicare's prospective payment system (PPS) for hospital cases is based on diagnosis-related groups (DRGs). A wide variety of other third-party payers for hospital care have adapted elements of this system for their own use. The extent of DRG use varies considerably both by type of payer and by geographical area. Users include: 21 State Medicaid programs, 3(More)
Hospital length of stay (LOS) declined steadily during the 1970s, then rapidly during the early years of the Medicare prospective payment system (PPS). In this article, the authors examine trends in hospital LOS for Medicare patients from 1979 through 1987 for all cases combined, for medical and surgical cases separately, and for different geographic(More)
The 28-percent change in average Medicare inpatient cost per case between 1984 and 1987 is decomposed into three components: input price inflation, changes in average cost within diagnosis-related groups (DRGs) (intensity), and changes in the distribution of cases across DRGs (case mix). We estimate the contributions of technology diffusion and outpatient(More)
and conclusions contained within this report are the sole responsibility of the authors. Acknowledgments The authors would like to thank Allison Diamant and Erin Salce for their thoughtful reviews and insights. Additionally, the authors would like to thank Molly Battistelli, Magaly Chavez, and Natasha Purington for their hard work and support of the Low(More)
BACKGROUND The Chinese government has provided health services to those infected by the human immunodeficiency virus (HIV) under the acquired immunodeficiency syndrome (AIDS) care policy since 2003. Detailed research on the actual expenditures and costs for providing care to patients with AIDS is needed for future financial planning of AIDS health care(More)
While the Affordable Care Act (ACA) is expected to reduce California's uninsurance rate by at least half, we project that between 2.7 and 3.4 million Californians will remain uninsured by 2019. Projections from the California Simulation of Insurance Markets (CalSIM) model indicate that up to half of Californians remaining uninsured will be undocumented(More)
The Medicare prospective payment system, which is based on the diagnosis-related group patient-classification system, identifies previously unrecognized redistributions of revenue among diagnosis-related groups and hospitals. The redistributions are caused by two artifacts. One artifact results from the use of labor market indexes to adjust costs for the(More)
model is designed to estimate the impacts of various elements of the Affordable Care Act on employer decisions to offer insurance coverage and individual decisions to obtain e Affordable Care Act (ACA) will significantly expand access to affordable health coverage in California, increasing the share of insured non-elderly Cali-fornians to nearly 90(More)