Strategic choices for cost containment under a reformed U.S. health care system.
The Clinton administration health reform proposal would impose global spending limits to bring the rate of increase in health care spending into line with the Consumer Price Index by 1999. This paper examines cost containment strategies available to states and health plans under externally imposed revenue limits. Drawing on the experience of state and local regulatory agencies, private sector managed care plans, and models in other countries, we contrast premium caps and provider rate setting as mechanisms to reduce growth in health care spending, and briefly consider the system-level regulatory structures necessary to oversee and control aggregate health care spending.
Kilbreth
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Center for Health Policy, Edmund S. Muskie Institute of Public Affairs, University of Southern Maine, Portland 04103.
Cohen
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AB
D002017:Budgets / Q000331:legislation & jurisprudence*; D002170:Canada; D002755:Choice Behavior; D003363:Cost Control / Q000331:legislation & jurisprudence / Q000379:methods; D016527:Drug Costs; D004465:Economic Competition; D005858:Germany; D018166:Health Care Reform / Q000191:economics*; D005102:Health Expenditures / Q000331:legislation & jurisprudence*; D006268:Health Facilities / Q000191:economics*; D006291:Health Policy; D008329:Managed Care Programs / Q000191:economics*; D017146:Models, Organizational; D011445:Prospective Payment System / Q000191:economics; D011907:Rate Setting and Review / Q000379:methods; D015895:Relative Value Scales; D013597:Systems Analysis; D014481:United States