Data and Code for: Impacts of Performance Pay for Hospitals: The Readmissions Reduction Program

Principal Investigator(s): View help for Principal Investigator(s) atul gupta, University of Pennsylvania. The Wharton School

Version: View help for Version V1

Name	File Type	Size	Last Modified
code-files			11/17/2020 04:18:PM
data			01/04/2021 04:59:PM
_README.txt	text/plain	1.7 KB	01/04/2021 12:24:PM

Project Citation:

gupta, atul. Data and Code for: Impacts of Performance Pay for Hospitals: The Readmissions Reduction Program. Nashville, TN: American Economic Association [publisher], 2021. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2021-03-19. https://doi.org/10.3886/E126841V1

Project Description

Summary:

US policy increasingly ties payments for providers to performance on quality measures, though little empirical evidence guides the design of such incentives. I deploy administrative data to study a large federal program that penalizes hospitals with high readmissions rates. Using policy-driven variation in the penalty incentive across hospitals for identication, I nd that hospital responses to the penalty account for two-thirds of the observed decrease in readmissions over this period, as well as a decrease in heart at-

tack mortality. Quality improvement accounts for about half of the decrease in readmissions; the remainder is explained by selective admission of returning patients.

Scope of Project

Subject Terms: instrumental variable; differences in differences; hospital readmissions; performance pay; Medicare

JEL Classification:
H00 Public Economics: General
I10 Health: General

Geographic Coverage: US

Time Period(s): 7/2006 – 6/2014 (2006-2014)

Universe: Medicare beneficiaries over age 65 in the US

Data Type(s): program source code

Methodology

Data Source: Primary data files are confidential and cannot be shared. These were obtained from:
1. Medicare claims - Centers for Medicare and Medicaid Services, 2006-14.
2. Hospital survey data - American Hospital Association annual surveys, 2006-14.

Public data files used in analysis are included in the packet:

CMS PUBLIC FILES:

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1. hospital_general_info - General hospital information like medicare provider id, name, zip, owner type, etc. Current version can be downloaded from https://data.medicare.gov/Hospital-Compare/Hospital-General-Information/xubh-q36u

2. hvbp-* - two files containing hospital penalty scores under the Hospital Value Based Purchasing program for FY2014. These files were downloaded from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits...

3. process_of_care_2007 - 2014 - files from CMS Hospital Compare containing process of care scores. These files were downloaded from https://data.medicare.gov/data/archives/hospital-compare

4. rsrr_by_condition_* - files from CMS containing hospital readmission rates (observed and risk adjusted) and penalty rates under HRRP. These files were downloaded from https://data.medicare.gov/data/archives/hospital-compare. Alternate versions available at https://data.nber.org/cms/readmissions/.

5. hosplist-2006:2015 - General information on hospitals recorded in CMS data;

Extracted from CMS hospital compare files for respective years from https://data.medicare.gov/data/archives/hospital-compare;

CROSS WALK FILES:

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6. hosp_hsa_hrr_2007 - crosswalk file from the Dartmouth atlas to bring in hospital HRR information. Current version can be downloaded from https://atlasdata.dartmouth.edu/downloads/supplemental#hospital.

7. ICD9 to CCS cross walk files - files from AHRQ. can be downloaded from NBER: https://data.nber.org/ahrq/ccs/

8. ICD9 to CC cross walk files -- needed to generate risk indicators used by CMS in adjusting readmissions for risk. Downloaded from https://www.qualitynet.org/inpatient/measures/readmission/resources#tab4

9. hosp10:14 - General information on hospitals, and crosswalk to hrr; 2010-14;

Downloaded "Hospital tracking files" from https://atlasdata.dartmouth.edu/downloads/supplemental#crosswalks

10. ssa_fips_state_county2011 - State to county FIPS code/name crosswalk; Downloaded from https://data.nber.org/ssa-fips-state-county-crosswalk/2011/

11. ZipHsaHrr10 - Zip code to HRR crosswalk; Downloaded from https://atlasdata.dartmouth.edu/downloads/geography/ZipHsaHrr10.xls;

ECONOMIC FACTOR CONTROLS:

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12. saipe-county-poverty-income - Data on county-level poverty rate, median hh income from Small Area Income & Poverty Estimates program of the US Census; Create using interactive tool at https://www.census.gov/programs-surveys/saipe/data/tools.html.;

13. state-insurance-1999-12-cps - Data from the CPS on state level medicaid and uninsurance share of population for people under 65; Downloaded from https://www2.census.gov/programs-surveys/demo/tables/health-insurance/time-series/hib/hihistt6b.xls;

14. state-insurance-2008-17-acs - Data from the ACS on state level medicaid and uninsurance share of population for people under 65; Downloaded from https://www2.census.gov/programs-surveys/demo/tables/health-insurance/time-series/acs/hic06_acs.xlsx;

15. laucnty06:15 - Data from the Bureau of Labor Services unemployment series (LAU); Created using interactive tool at https://www.bls.gov/lau/data.htm

16. cpiu-2005-2016 - Data from BLS CPIU series used to deflate spending to 2016 dollars; Available at https://www.bls.gov/cpi/data.htm;

Unit(s) of Observation: patient-level claims, hospital -year quality and penalty, county -year economic performance

Geographic Unit: county

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V1 [2021-03-19]

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