Medicare payment policy and the controversy over hospital cost shifting

Applied Health Economics and Health Policy

Volumn 3, Issue 3, 2004, Pages 153-159

  Mayes, Rick ^a,b   Lee, Jason S ^c  

^a UNIVERSITY OF RICHMOND   (United States)

^b School of Public Health   (United States)

^c National Institute for Healthcare Management   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH PROGRAM; HOSPITAL COST; MEDICARE; REIMBURSEMENT; REVIEW; UNITED STATES;

COST ALLOCATION; COST CONTROL; COST SHARING; FINANCING, GOVERNMENT; FINANCING, PERSONAL; HOSPITAL COSTS; MEDICARE; MODELS, ECONOMIC; ORGANIZATIONAL POLICY; UNITED STATES;

EID: 22544436129     PISSN: 11755652     EISSN: 11755652     Source Type: Journal    
DOI: 10.2165/00148365-200403030-00006     Document Type: Review

References (56)

1. The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. 2004 Annual report of the boards of trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance trust funds [online]. Available from URL: http://www.cms.hhs.gov/ publications/trusteesreport/2004/tr.pdf [Accessed 2004 Dec 1]
2. Lefton R. What's it worth? Healthc Financ Manage 2003 Dec; 57: 60-4
3. David Abernethy, interviewed by Rick Mayes; 2002 June 19
4. Ginsburg P. Can hospitals and physicians shift the effects of cuts in Medicare reimbursement to private payers? Health Aff (Millwood) 2003 Jul-Sep; Suppl. Web Exclusives: W3-472-W3-479
5. Robert Winters (former President of Prudential Insurance and head of the Business Roundtable's Health Care Task Force), interviewed by Rick Mayes; 2002 Aug 28
6. Johnson A, Aquilina D. The cost shifting issue. Health Aff (Millwood) 1982; 1 (4): 101-6
7. Guterman S, Ashby J, Greene T. Hospital cost growth down. Health Aff (Millwood) 1996; 15 (3): 134-9
8. Morrisey MA. Hospital cost shifting, a continuing debate [online]. Employee Benefit Research Institute, issue brief no. 180, December 1996. Available from URL: http://www.ebri.org/ibpdfs/1296ib.pdf [Accessed 2004 Oct 1]
9. Zwanziger J, Melnick G, Bamezai A. Can cost shifting continue on a price competitive environment? Health Econ 2000 Apr; 9 (3): 211-25
10. Clement JP. Dynamic cost shifting in hospitals: evidence from the 1980s and 1990s. Inquiry 1997-1998; 34 (4): 340-50
11. Mitchell JM, Hadley J, Gaskin DJ. Physician's responses to Medicare fee schedule reductions. Med Care 2000 Oct; 38 (10): 1029-39
12. Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Medicare payment policy [online]. Available from URL: http://www.medpac.gov/ publications/congressional_reports/Mar03_Entire_report.pdf [Accessed 2004 Dec 1]
13. Morrisey MA. Cost shifting: new myths, old confusion, and enduring reality. Health Aff (Millwood) 2003 Jul-Dec; Suppl. Web Exclusives: W3-489-W3-491
14. Kahn C. When public payment declines, does cost-shifting occur? Hospital and physician responses; 2002 Nov 13; Washington, DC. Conference transcript available from URL: http://www.kaisernetwork.org/health_cast/uploaded_ files/111302_hcfo_costsharing.pdf [Accessed 2004 Oct 1]
15. Donald A. Young, interviewed by Rick Mayes; 2002 Oct 11
16. Melnick G. Witness testimony in: Hearing on the uninsured. Hearing before the Subcommittee on Health of the Committee on Ways and Means, US House of Representatives, 108th Congress, 2nd Session (2004 Mar 9) [online]. Available from URL: http://waysandmeans.house.gov/hearings.asp?formmode=view&id= 2190#Melnick [Accessed 2004 Oct 1]
17. Dobson A, DaVanzo J, Sen N. Cost shifting: an integral aspect of US health care finance [online]. Available from URL: http://www.hcfo.net/pdf/ dobson.pdf [Accessed 2004 Oct 1]
18. American Hospital Association. Trendwatch chartbook 2001: trends affecting hospitals and health systems [online]. Available from URL: http://www.hospitalconnect.com/ahapolicyforum/trendwatch/chartbook2001.html
19. Ginsburg P. Can hospitals and physicians shift the effects of cuts in Medicare reimbursement to private payers? Health Aff (Millwood) 2003 Jul-Sep; Suppl. Web Exclusives: W3-472-W3-479
20. Guterman S. When public payment declines, does cost-shifting occur? Hospital and physician responses; 2002 Nov 13; Washington, DC. Conference transcript available from URL: http://www.kaisernetwork.org/health_cast/ uploaded_files/111302_hcfo_costsharing.pdf [Accessed 2004 Oct 1]
21. Guterman S. Putting Medicare in context: how does the Balanced Budget Act affect hospitals? [research paper]. Health Policy Center, The Urban Institute (2000 Jul) [online]. Available from URL: http://www.urban.org/UploadedPDF/ medicare-context.pdf [Accessed 2004 Oct 1]
22. Melnick G, Keeler E, Zwanziger J. Market power and hospital pricing: are nonprofits different? Health Aff (Millwood) 1999; 18 (3): 167-73
23. Keeler E, Melnick G, Zwanziger J. The changing effects of competition on non profit and for-profit hospital pricing behavior. J Health Econ 1999; 18: 69-86
24. Dranove D, Ludwick R. Competition and pricing by nonprofit hospitals: a reassessment of Lynk's analysis. J Health Econ 1999; 18: 87-98
25. Anderson G. A review of hospital billing and collection practices. Witness testimo-ny in: Hearing before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives, 108th Con gress, 2nd Session (2004 June 24) [online]. Available from URL: http://energycommerce.house.gov/108/Hearings/06242004hearing1299/ Anderson2095.htm [Accessed 2004 Nov 8]
26. Mann J, Melnick G, Bamezai A, et al. Uncompensated care: hospitals' responses to fiscal pressures. Health Aff (Millwood) 1995; 14 (1): 263-70
27. Feldstein P. Health policy issues: an economic perspective. 3rd ed. Chicago: Health Administration Press, 2003: 187-97
28. Roberts RR, Frutos PW, Ciavarella GG, et al. Distribution of variable vs fixed costs of hospital care. JAMA 1999; 281 (7): 644-9
29. Meyer JA, Johnson WR. Cost shifting in health care: an economic analysis. Health Aff (Millwood) 1983; 2 (2): 20-35
30. James Mongan, interviewed by Rick Mayes; 2002 Oct 4
31. Hadley J, Holahan J. How much medical care do the uninsured use, and who pays for it? Health Aff (Millwood) 2003; Suppl. Web Exclusives: W3-66-W3-81
32. Mann J, Melnick G, Bamezai A, et al. Uncompensated care: hospitals' responses to fiscal pressures. Health Aff (Millwood) 1995; 14 (1): 263-70
33. Atkinson G, Helms WD, Needleman J. State trends in hospital uncompensated care. Health Aff (Millwood) 1997; 16 (4): 233-41
34. Lisa Potetz, interviewed by Rick Mayes; 2002 Jul 24
35. Leon Panetta, interviewed by Rick Mayes; 2002 Aug 13
36. Bill Gradison, interviewed by Rick Mayes; 2002 Jun 12
37. Rick Pollack, interviewed by Rick Mayes; 2002 Dec 27
38. Foster RS. Trends in Medicare expenditures and financial status, 1966-2000. Health Care Financ Rev 2000; 22: 35-41
39. Committee on Ways and Means, Subcommittee on Health. Thomas announces hearing on additional Medicare refinements to the Balanced Budget Act of 1997 (media release) [online]. 2000 Jul 18. Available from URL: http://waysandmeans. house.gov/legacy/health/106cong/hl-15.htm [Accessed 2004 Oct 1]
40. Board of Trustees, Federal Hospital Insurance Trust Fund. 1996 Annual report on Federal Hospital Insurance Trust Fund, House Committee on Ways and Means. Washington, DC: Government Printing Office, 1996
41. Medicare Payment Advisory Commission (MedPAC). Report to the Congress: selected Medicare issues. Washington, DC: MedPAC, 2000 Jun
42. Medicare Prospective Payment Advisory Committee. The relationship of hospital costs and payment by source of revenue [intramural report I-95-01]. Washing-ton, DC: ProPAC, 1995 Oct
43. Lee JS, Berenson RA, Mayes R, et al. Medicare payment policy: does cost shifting matter? Health Aff (Millwood) 2003; Suppl. Web Exclusives: W3-480-W3-488. Available from URL: http://content.healthaffairs.org/cgi/content/ full/hlthaff.w3.480v1/DC1 [Accessed 2003 Oct 8]
44. American Hospital Association. Trendwatch chartbook 2004: trends affecting hospitals and health systems [online]. Available from URL: http://www.hospitalconnect.com/ahapolicyforum/trendwatch/chartbook2004.html [Accessed 2004 Dec 1]
45. American Hospital Association. Fast facts on US hospitals from AHA hospital statistics. [online]. Available from URL: http://www.hospitalconnect. com/aha/resource_center/fastfacts/fast_facts_US_hospitals.html [Accessed 2004 Dec 1]
46. Cuellar A, Gertler P. Trends in hospital consolidation: the formation of local systems. Health Aff (Millwood) 2003; 22 (6): 77-87
47. Centers for Medicare and Medicaid Services. Highlights - National Health Ex-penditures, 2003 [online]. Available from URL: http://www.cms.hhs.gov/ statistics/nhe/historical/highlights.asp [Accessed 2004 Oct 1]
48. Levit K, Smith C, Cowan C, et al. Health spending rebound continues in 2002. Health Aff (Millwood) 2004; 23 (1): 147-59
49. Cunningham R. Hospital finance: signs of 'pushback' amid resurgent cost pressures. Health Aff (Millwood) 2001; 20 (2): 233-40
50. Center for Studying Health System Change. Tracking health care costs: trends turn downward in 2003 (data bulletin no. 27) [online]. Available from URL: http://www.hschange.org/CONTENT/679/679.pdf [Accessed 2004 Oct 1]
51. Fletcher RH. Who is responsible for the common good in a competitive market? JAMA 1999; 281: 1127-8
52. Freudenheim M. Workers feel pinch of rising health costs. New York Times 2003 Oct 22; Sect. C: 1
53. Geisel J. Cost-shifting helping lower health inflation. Bus Insur 2003; 37: 1
54. Gabel J, Claxton G, Holve E, et al. Health benefits in 2003: premiums reach thirteen-year high as employers adopt new forms of cost sharing. Health Aff (Millwood) 2003; 22 (5): 117-26
55. Edwards JN, Doty MM, Schoen C. The erosion of employer-based health coverage and the threat to workers' health care: findings from The Commonwealth Fund 2002 Workplace Health Insurance Survey (The Commonwealth Fund issue brief) [online]. Available from URL: http://www.cmwf.org/usr_doc/edwards_erosion.pdf [Accessed 2004 Oct 1]
56. McLaughlin CG, Mortensen K. Who walks through the door? The effect of the uninsured on hospital use. Health Aff (Millwood) 2003; 22 (6): 143-55