New Findings from University of Pennsylvania Describe Advances in Managed Care (Improving the Evaluation of Low-Volume Hospitals): Managed Care

2026 FEB 13 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators discuss new findings in Managed Care. According to news reporting out of Philadelphia, Pennsylvania, by NewsRx editors, research stated, “Low volume has been recognized as a problem when benchmarking hospitals due to outcome rate instability. We asked if low-volume hospital outcomes, using matching to control for many clinical and sociodemographic characteristics, would expose quality problems not observed with CMS methods. Matched cohort study.”

Our news journalists obtained a quote from the research from the University of Pennsylvania, “Grades derive from mortality differences between all patients at the low-volume hospital and their matched controls. Medicare patients admitted with Acute Myocardial Infarction, Heart Failure and Pneumonia in 78 low-volume Pennsylvania acute care hospitals (combined condition volume=75 N 750 for the 3 y, 2017-2019), using Medicare’s Virtual Research Data Center. Thirty-day mortality. Using matching, 10 of 78 reportable low-volume hospitals had significantly higher mortality versus matched typical controls and 16 low-volume hospitals displayed significantly higher mortality versus well-resourced controls. In contrast, Medicare reported that only 3 of these same 78 hospitals had significantly higher mortality than ‘the national rate’ on AMI, HF, or pneumonia. We find that some low-volume hospitals performed well. Other low-volume hospitals had significantly worse outcomes than both well-resourced and typical hospitals; and some displayed significantly worse mortality compared with well-resourced controls but did not reach significant differences from typical controls. In short, performing ‘no different from the national rate,’ as is almost always reported for low-volume hospitals when using CMS methods, does not imply a low-volume hospital has acceptable outcomes. Reports based on matching can expose low-volume hospital quality problems not apparent using standard methods.”

According to the news editors, the research concluded: “Low-volume hospitals have more quality problems than generally reported.”

This research has been peer-reviewed.

For more information on this research see: Improving the Evaluation of Low-Volume Hospitals. Medical Care, 2026. Medical Care can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Medical Care - http://journals.lww.com/lww-medicalcare/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting Paul R. Rosenbaum, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA. Additional authors for this research include Jeffrey H. Silber, Joseph G. Reiter, Alexander S. Hill and Lee A. Fleisher.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/mlr.0000000000002292. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Medical Care is: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.

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