W. Pete Welch

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  • W P Welch
  • Advances in health economics and health services…
  • 1985
The literature suggests four basic "facts" about biased selection in PGPs: First, the well disproportionally enroll in PGPs. Second, for a group defined according to low expenditure, expenditure regresses toward the mean. Whether this is applicable to PGPs is unclear. Third, the well disproportionally disenroll from PGPs. Finally, although more evidence is(More)
BACKGROUND Medicare's home health care program, consisting primarily of home visits by nurses and health aides, was conceived as a means to facilitate hospital discharge. Because home health care is now one of the fastest-growing categories of Medicare expenditures, we analyzed Medicare claims data to determine current patterns of use. METHODS We used(More)
One legislative policy option for controlling postacute care costs is for Medicare to make a "bundled" payment to hospitals to cover episode costs: acute plus postacute care costs. But a bundled payment might not match the costs of treatment as well as payment now does under Medicare's prospective payment system (PPS). Simulating hospital margins with and(More)
This paper develops a geographic index of physician practice costs. A Laspeyres index is derived for each Metropolitan Statistical Area and for the non-metropolitan portion of each state. Relative prices by area are obtained for four practice inputs: physicians' own time, employee wages, office rents, and malpractice insurance. Each input price proxy is(More)
  • W P Welch
  • Inquiry : a journal of medical care organization…
  • 1987
Although teaching hospitals are widely discussed in terms of 115 university teaching hospitals, Medicare's prospective payment system pays about 1,000 teaching hospitals an additional amount per case. This paper investigates two frequent justifications for this add-on payment: 1) teaching hospitals have sicker patients, and 2) they produce medical(More)
  • W P Welch
  • Inquiry : a journal of medical care organization…
  • 1991
Defining geographic areas for the purpose of paying health care providers has been difficult and is an issue that Congress continues to address. Employment-based insurance programs are starting to face this same issue in paying HMOs. Because input prices are related to population density, payment levels could be related to density. This paper offers a new(More)
Payers are increasingly using diagnostic data from outpatient encounter records to adjust the payment to health plans. Although much has been written about the ability of such data to predict health care costs, little has been written about the data itself--its quality and availability. Fee-for-service (FFS) data face several threats to their validity,(More)
BACKGROUND The national volume-performance standard recently implemented by Medicare does not account for geographic variation in expenditures for physicians' services. To study this variation, we examined expenditures for physicians' services in all metropolitan areas in the United States. METHODS We used Medicare claims data for 1989 to measure rates of(More)
As a result of the Food and Drug Administration (FDA) Modernization Act and the Best Pharmaceuticals for Children Act, the number of medications with FDA-approved pediatric labeling has increased. To assess the success of these initiatives, we examined whether antihypertensive drugs used by children with hypertension in 2008 had FDA-approved pediatric(More)
BACKGROUND Physician profiling is a method of cost control that focuses on patterns of care instead of on specific clinical decisions. It is one cost-control method that takes into account physicians' desire to curb the intrusion of administrative mechanisms into the clinical encounter. To provide a concrete example of profiling, we analyzed the inpatient(More)