Do Medicare and Medicaid Payer-Mix Change After the Privatization of Public Hospitals?

Academic Article


  • This study assessed the impact of public hospitals’ privatization on payer-mix. We used a national sample of nonfederal, acute care, public hospitals in 1997 and followed them through 2013, resulting in a cohort of 492 hospitals (8,335 hospital-year observations). Privatization to for-profit (FP) status was associated with a greater increase in Medicare payer-mix (β = 0.13; p ≤.001), compared with a smaller increase for privatization to not-for-profit (NFP) status (β = 0.02; p ≤.05). FP privatization was associated with a greater decrease in Medicaid payer-mix (β = −0.09; p ≤.001), compared with NFP privatization (nonsignificant). There is a larger change in payer-mix after FP privatization than after NFP privatization.
  • Digital Object Identifier (doi)

    Author List

  • Ramamonjiarivelo Z; Weech-Maldonado R; McRoy L; Epané JP; Zengul FD; Hearld L
  • Start Page

  • 361
  • End Page

  • 370
  • Volume

  • 78
  • Issue

  • 4