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M D Rosko

Publications and source records attributed to M D Rosko.

45 records · Page 3Linked to original sources
PubMed1985

A qualitative assessment of the Medicare prospective payment system.

This paper employs commonly accepted criteria to evaluate the potential outcomes of the Medicare pricing mechanism. The analysis suggests that the recent revisions in the Medicare payment system have less potential to contain increases in total hospital costs than those embodied in all-payer systems. In addition, this paper also suggests that the pricing mechanism will jeopardize the financial viability of many hospitals while exacerbating inequities that emanate from differential pricing policies. Finally, when viewed from the perspective of insured beneficiaries, it is reasonable to expect that the payment mechanism will reduce not only access to inpatient care but also the use of service once admitted.

Diagnosis-Related Groups↗
PubMed1985

Strategic marketing applications of conjoint analysis: an HMO perspective.

The purpose of this article is to demonstrate how data from a conjoint analysis study can be used to help determine the most appropriate marketing mix for an operational HMO which is entering a new market--the geriatric population. Included are two features which are absent in previous articles on health care applications of conjoint analysis: external validation of results, and a demonstration of how conjoint analysis can be used to simulate market responses to changes in the provider's marketing mix.

Analysis of Variance↗
PubMed1984

The impact of prospective payment: a multi-dimensional analysis of New Jersey's SHARE program.

The SHARE program, which set per diem prospective rates for New Jersey hospitals during the period 1975-1982, is evaluated. Analysis suggests that this program did contain hospital cost increase. However, the program threatened the viability of most inner-city hospitals. Indirect evidence suggests that there was cost-shifting in response to this program, which regulated payment for only Blue Cross and Medicaid patients. Structural features of this program and its successor, the New Jersey DRG program, are analyzed; and implications for the Medicare prospective payment system are examined.

Cost Allocation↗
PubMed1983

Measuring consumer preferences for ambulatory medical care arrangements.

This paper describes how conjoint analysis can be applied to health care marketing. Data from a sample of 73 university students were used to estimate part-worth values for different levels of attributes of ambulatory care arrangements. A high degree of comparative validity was found.

Ambulatory Care Facilities↗
PubMed1983

Modeling consumer choices of health plans: a comparison of two techniques.

This paper has two objectives. First, we will describe how conjoint measurement, a multivariate marketing research technique, can be applied in health care marketing. Second, we will compare the validity of results from two conjoint measurement techniques--the full profile approach and the tradeoff approach. A convenience sample of 97 university students was used in the study. Fifty-two students supplied data by using the full profile approach. Each respondent provided a complete rank order of 26 profile cards which included the following ambulatory health service attributes: charge for routine visit, travel time, office hours, length of time needed to make an appointment, waiting time in physician's office, practice arrangement/freedom of physician choice, parking arrangements and type of hospital. A fractional factorial design was used to determine different attribute levels (e.g. charge for routine office visit could be set at $10, $20 or $30) for each card. Forty-five students performed ranking tasks for the trade-off approach to conjoint measurement. These respondents ranked 28 grids which represent all combinations of factors taken two at a time. From the data collected in the ranking tasks, utilities or part-worth values for each level of each attribute were estimated by using dummy variable regression. Relative importance of ambulatory service attributes was inferred from the range of utility values of the attributes. Three measures of validity were assessed--adherence of estimated utility scores to monotonic assumptions, plausability of importance rankings and comparative validity. The results from the full-profile approach satisfied all three criteria. In contrast, the tradeoff approach results satisfied the first two criteria, but its comparative validity was only marginal. Valid conjoint data can be used for: simulations of market responses to different health services configurations; market segmentation studies; and development of promotional efforts.

Ambulatory Care↗
PubMedDate not supplied

Strategic hospital marketing responses to prospective payment.

Hospitals may respond to the revenue constraints of prospective payment by altering their patient mix. This article provided a brief overview of marketing management and suggested that hospitals might change their patient mix by employing marketing strategies designed to attract patients to its services or to attract physicians who specialize in the appropriate medical disciplines.

Ambulatory Care↗
PubMedDate not supplied

Potential responses to the Medicare pricing mechanism.

This article describes the Medicare pricing mechanism and explores potential responses to the reliance on the patient and related medical condition as the unit of payment. The analysis suggests that, although the provisions of PL 98-21 may benefit the Medicare program, the pricing system may jeopardize the financial viability of hospitals, increase inequities that emanate from differential pricing policies and, when viewed from the perspective of beneficiaries, reduce access to in-hospital care and the use of service once admitted.

Diagnosis-Related Groups↗