DOI

10.1377/hlthaff.W3.480

Abstract

We examine cost shifting within the context of Medicare payment policy. We briefly review economic theory and available data and discuss the importance of cost shifting for policy. Then we present four central findings on cost shifting based on the views of former high-level policymakers. First, Medicare’s early (pre-prospective) payment policy was a boon to hospitals. Second, Medicare payment policy is a “top-down” affair, driven by budgetary and special-interest politics. Third, federal policymakers may not consciously consider cost shifting, but state policymakers do. Fourth, Medicare payment policy requires constant adjustment, but we are “getting it right” most of the time.

Document Type

Article

Publication Date

10-8-2003

Publisher Statement

Copyright © 2003, People-to-People Health Foundation, Inc. This article first appeared in Health Affairs (2003).

Please note that downloads of the article are for private/personal use only.

Share

COinS