{"id":"https://openalex.org/W7225184483","doi":"https://doi.org/10.1111/1475-6773.70178","title":"The Association of Hospital Characteristics With Medicaid Managed Care Hospital Prices","display_name":"The Association of Hospital Characteristics With Medicaid Managed Care Hospital Prices","publication_year":2026,"publication_date":"2026-11-02","ids":{"openalex":"https://openalex.org/W7225184483","doi":"https://doi.org/10.1111/1475-6773.70178","pmid":"https://pubmed.ncbi.nlm.nih.gov/42972859","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13728323"},"language":"en","primary_location":{"id":"doi:10.1111/1475-6773.70178","doi":"https://doi.org/10.1111/1475-6773.70178","is_oa":true,"landing_page_url":"https://doi.org/10.1111/1475-6773.70178","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.70178","source":{"id":"https://openalex.org/S2228914","display_name":"Health Services Research","issn_l":"0017-9124","issn":["0017-9124","1475-6773"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-a","anvur-class-a","anvur-scientific","cwts-core","dongbi-c","doyens","fnege-2","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Services Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.70178","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5030515653","display_name":"Brett Alfrey","orcid":"https://orcid.org/0000-0001-7477-6301","observed_orcids":["https://orcid.org/0000-0001-7477-6301"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Brett Alfrey","raw_affiliation_strings":["Elevance Health Public Policy Institute  Washington District of Columbia USA"],"raw_orcid":"https://orcid.org/0000-0001-7477-6301","affiliations":[{"raw_affiliation_string":"Elevance Health Public Policy Institute  Washington District of Columbia USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061005073","display_name":"Benjamin D. Ukert","orcid":"https://orcid.org/0000-0002-2337-9573","observed_orcids":["https://orcid.org/0000-0002-2337-9573"]},"institutions":[{"id":"https://openalex.org/I45438204","display_name":"The University of Texas at San Antonio","ror":"https://ror.org/01kd65564","country_code":"US","type":"education","lineage":["https://openalex.org/I45438204"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Benjamin Ukert","raw_affiliation_strings":["Department of Economics Carlos Alvarez College of Business, University of Texas at San Antonio  San Antonio Texas USA"],"raw_orcid":"https://orcid.org/0000-0002-2337-9573","affiliations":[{"raw_affiliation_string":"Department of Economics Carlos Alvarez College of Business, University of Texas at San Antonio  San Antonio Texas USA","institution_ids":["https://openalex.org/I45438204"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5010994475","display_name":"Aliza S. Gordon","orcid":"https://orcid.org/0000-0003-4565-0771","observed_orcids":["https://orcid.org/0000-0003-4565-0771"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Aliza S. Gordon","raw_affiliation_strings":["Elevance Health Public Policy Institute  Washington District of Columbia USA"],"raw_orcid":"https://orcid.org/0000-0003-4565-0771","affiliations":[{"raw_affiliation_string":"Elevance Health Public Policy Institute  Washington District of Columbia USA","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5030515653"],"corresponding_institution_ids":[],"apc_list":{"value":3750,"currency":"USD","value_usd":3750},"apc_paid":{"value":3750,"currency":"USD","value_usd":3750},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.88967145,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"61","issue":"6","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hospital-prices","display_name":"hospital prices","score":0.8360000252723694},{"id":"https://openalex.org/keywords/medicaid-managed-care","display_name":"Medicaid managed care","score":0.984000027179718},{"id":"https://openalex.org/keywords/hospital-characteristics","display_name":"hospital characteristics","score":0.7269999980926514},{"id":"https://openalex.org/keywords/children-s-hospitals","display_name":"children's hospitals","score":0.9330000281333923},{"id":"https://openalex.org/keywords/critical-access-hospitals","display_name":"critical access hospitals","score":1.0},{"id":"https://openalex.org/keywords/routine-procedures","display_name":"routine procedures","score":0.6230000257492065},{"id":"https://openalex.org/keywords/tympanostomy","display_name":"tympanostomy","score":0.8849999904632568},{"id":"https://openalex.org/keywords/colonoscopy","display_name":"colonoscopy","score":0.9829999804496765},{"id":"https://openalex.org/keywords/magnetic-resonance-imaging","display_name":"magnetic resonance imaging","score":0.6159999966621399},{"id":"https://openalex.org/keywords/hospital-size","display_name":"hospital size","score":0.5509999990463257},{"id":"https://openalex.org/keywords/teaching-hospitals","display_name":"teaching hospitals","score":0.6380000114440918},{"id":"https://openalex.org/keywords/for-profit-hospitals","display_name":"for-profit hospitals","score":0.7440000176429749},{"id":"https://openalex.org/keywords/public-hospitals","display_name":"public hospitals","score":0.628000020980835},{"id":"https://openalex.org/keywords/rural-hospitals","display_name":"rural hospitals","score":0.6110000014305115}],"concepts":[{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.8007000088691711},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7892000079154968},{"id":"https://openalex.org/C73269764","wikidata":"https://www.wikidata.org/wiki/Q954529","display_name":"Poisson regression","level":3,"score":0.7095000147819519},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.4643999934196472},{"id":"https://openalex.org/C2781385661","wikidata":"https://www.wikidata.org/wiki/Q4677918","display_name":"Acute care","level":3,"score":0.44029998779296875},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.4120999872684479},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.3880000114440918},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3783999979496002},{"id":"https://openalex.org/C2777683733","wikidata":"https://www.wikidata.org/wiki/Q201456","display_name":"Directory","level":2,"score":0.3522000014781952},{"id":"https://openalex.org/C2780265253","wikidata":"https://www.wikidata.org/wiki/Q1416012","display_name":"Managed care","level":3,"score":0.3452000021934509},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.33739998936653137},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.33410000801086426},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.3172000050544739},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.31049999594688416},{"id":"https://openalex.org/C27403532","wikidata":"https://www.wikidata.org/wiki/Q5532474","display_name":"Generalized estimating equation","level":2,"score":0.3084000051021576},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.3019999861717224},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.30079999566078186},{"id":"https://openalex.org/C2993624421","wikidata":"https://www.wikidata.org/wiki/Q16917","display_name":"Hospital care","level":3,"score":0.2930999994277954},{"id":"https://openalex.org/C2775909303","wikidata":"https://www.wikidata.org/wiki/Q3259564","display_name":"Inpatient care","level":3,"score":0.27619999647140503},{"id":"https://openalex.org/C167704817","wikidata":"https://www.wikidata.org/wiki/Q7295548","display_name":"Rate ratio","level":3,"score":0.27399998903274536},{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.26840001344680786},{"id":"https://openalex.org/C2910366845","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Physician Office","level":3,"score":0.2596000134944916},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.25369998812675476},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.2535000145435333}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003430","descriptor_name":"Cross-Sectional Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008329","descriptor_name":"Managed Care Programs","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D008329","descriptor_name":"Managed Care Programs","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D008484","descriptor_name":"Medicaid","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D008484","descriptor_name":"Medicaid","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017722","descriptor_name":"Hospital Charges","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1111/1475-6773.70178","doi":"https://doi.org/10.1111/1475-6773.70178","is_oa":true,"landing_page_url":"https://doi.org/10.1111/1475-6773.70178","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.70178","source":{"id":"https://openalex.org/S2228914","display_name":"Health Services Research","issn_l":"0017-9124","issn":["0017-9124","1475-6773"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-a","anvur-class-a","anvur-scientific","cwts-core","dongbi-c","doyens","fnege-2","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Services Research","raw_type":"journal-article"},{"id":"pmid:42972859","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42972859","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health services research","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13728323","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728323/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Serv Res","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1111/1475-6773.70178","doi":"https://doi.org/10.1111/1475-6773.70178","is_oa":true,"landing_page_url":"https://doi.org/10.1111/1475-6773.70178","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.70178","source":{"id":"https://openalex.org/S2228914","display_name":"Health Services Research","issn_l":"0017-9124","issn":["0017-9124","1475-6773"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-a","anvur-class-a","anvur-scientific","cwts-core","dongbi-c","doyens","fnege-2","jufo-3","ki-jl-1","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Services Research","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9537000060081482},{"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities","score":0.5}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225184483.pdf","grobid_xml":"https://content.openalex.org/works/W7225184483.grobid-xml"},"referenced_works_count":28,"referenced_works":["https://openalex.org/W784437528","https://openalex.org/W1980575879","https://openalex.org/W2012665972","https://openalex.org/W2040155838","https://openalex.org/W2067302710","https://openalex.org/W2098113104","https://openalex.org/W2122838961","https://openalex.org/W2203602098","https://openalex.org/W2210601085","https://openalex.org/W2329648712","https://openalex.org/W2613218900","https://openalex.org/W2883493932","https://openalex.org/W2937842726","https://openalex.org/W2948165753","https://openalex.org/W2980665181","https://openalex.org/W3016447762","https://openalex.org/W3121510792","https://openalex.org/W4223461921","https://openalex.org/W4283390328","https://openalex.org/W4311473472","https://openalex.org/W4383645966","https://openalex.org/W4389082582","https://openalex.org/W4392845319","https://openalex.org/W4404199225","https://openalex.org/W4407166416","https://openalex.org/W4411627956","https://openalex.org/W4412847990","https://openalex.org/W7171515574"],"related_works":["https://openalex.org/W4389082582","https://openalex.org/W4410030624","https://openalex.org/W4393008700","https://openalex.org/W7092282131","https://openalex.org/W7161962100","https://openalex.org/W4390105248","https://openalex.org/W4389687866","https://openalex.org/W4408530985","https://openalex.org/W2551009221","https://openalex.org/W2940760374"],"abstract_inverted_index":{"OBJECTIVE:":[0],"To":[1],"examine":[2],"the":[3,46,58,90,108,133,155,187,229,248,300],"association":[4],"between":[5],"various":[6],"hospital":[7,61,68,81,139,203,269,304],"characteristics":[8],"and":[9,57,80,118,121,146,169,212,245,285],"Medicaid":[10,33,277],"facility":[11,27,49,101,280],"prices":[12,175,208,215,222,281],"for":[13,53,103,191,209,216,223,227,233,246,252,267,287],"several":[14,288],"routine":[15,105,289],"procedures.":[16,218,290],"STUDY":[17],"SETTING":[18],"AND":[19,95],"DESIGN:":[20],"We":[21,40,83,98],"conducted":[22],"a":[23],"cross-sectional":[24],"study":[25,142,273],"of":[26,55,154,157],"claims":[28,102,127],"data":[29,131],"from":[30,35,89,132],"Elevance":[31],"Health-affiliated":[32],"plans":[34],"22":[36],"states":[37],"plus":[38],"D.C.":[39],"estimated":[41],"Poisson":[42],"regression":[43,91],"models":[44],"where":[45],"outcome":[47],"was":[48,190,232,251],"allowed":[50],"cost":[51],"(\"price\")":[52],"procedures":[54,106,156,211],"interest,":[56],"exposures":[59],"were":[60,128,165,176,265],"characteristics,":[62],"including":[63,115],"children's":[64,167,179,283],"hospital,":[65],"critical":[66],"access":[67],"(CAH),":[69],"rurality,":[70],"system":[71],"affiliation,":[72,77],"teaching":[73],"designation,":[74],"for-profit,":[75],"religious":[76],"government":[78],"ownership,":[79],"size.":[82],"report":[84],"incidence":[85],"rate":[86],"ratios":[87],"(IRRs)":[88],"estimates.":[92],"DATA":[93],"SOURCES":[94],"ANALYTIC":[96],"SAMPLE:":[97],"analyzed":[99],"2021-2023":[100],"11":[104],"in":[107,303],"outpatient":[109,217],"or":[110],"emergency":[111],"department":[112],"(ED)":[113],"settings,":[114],"tympanostomy,":[116],"colonoscopy,":[117],"ED":[119,192,210],"evaluation":[120],"management":[122],"(E/M)":[123],"Levels":[124],"2-5.":[125],"The":[126,141,161],"joined":[129],"with":[130],"American":[134],"Hospital":[135],"Directory":[136],"to":[137,182,295],"identify":[138],"characteristics.":[140,270],"included":[143],"2,250,325":[144],"children":[145,228],"2,341,063":[147],"adults":[148,247],"who":[149],"received":[150],"at":[151,166,178,282],"least":[152],"one":[153],"interest.":[158],"PRINCIPAL":[159],"FINDINGS:":[160],"largest":[162,188,230,249],"price":[163],"differences":[164,302],"hospitals":[168,180,284],"CAHs.":[170],"For":[171],"all":[172,225],"child":[173],"procedures,":[174],"higher":[177,207,214,221,243,262,276],"relative":[181],"other":[183,268],"acute":[184],"care":[185,279],"hospitals:":[186],"estimate":[189,231,250],"E/M":[193],"Level":[194],"2":[195],"(IRR":[196,235,254],"=":[197,236,255],"2.51;":[198],"95%":[199,238,257],"CI,":[200,239,258],"2.14-2.95).":[201],"Children's":[202],"estimates":[204],"represented":[205],"93%-151%":[206],"23%-48%":[213],"CAHs":[219,286],"had":[220],"almost":[224],"procedures:":[226],"tympanostomy":[234],"1.78;":[237],"1.45-2.18),":[240],"representing":[241,260],"78%":[242],"prices,":[244],"MRI":[253],"2.43;":[256],"2.13-2.76),":[259],"143%":[261],"prices.":[263,305],"Results":[264],"mixed":[266],"CONCLUSIONS:":[271],"This":[272],"suggests":[274],"much":[275],"managed":[278],"More":[291],"research":[292],"is":[293,298],"needed":[294],"understand":[296],"what":[297],"driving":[299],"observed":[301]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-11-04T00:00:00"}