OECD Health Working Papers

This series is designed to make available to a wider readership health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language - English or French - with a summary in the other.

English, French

Tapering payments in hospitals

Experiences in OECD countries

This study covers “tapering scale” mechanism in hospital payments, i.e. mechanisms linking unit prices to the volume of services produced. This paper begins with an overview of hospital services and hospital payment methods in OECD countries, focusing more specifically on DRG-based payment. It then reviews studies published on economies of scales in hospitals, which is the economic rationale justifying tapering payments. Thereafter, four case studies from Germany, the US State of Maryland, the Czech Republic and Israel offer a detailed insight into the practicalities of introducing this method of controlling hospital volumes and the impacts it has had.


JEL: D22: Microeconomics / Production and Organizations / Firm Behavior: Empirical Analysis; D24: Microeconomics / Production and Organizations / Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity; L84: Industrial Organization / Industry Studies: Services / Personal, Professional, and Business Services; I18: Health, Education, and Welfare / Health / Health: Government Policy; Regulation; Public Health; L88: Industrial Organization / Industry Studies: Services / Industry Studies: Services: Government Policy; H51: Public Economics / National Government Expenditures and Related Policies / Government Expenditures and Health
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