Rate regulation as a policy tool: lessons from New York State.
For over a decade, New York State has used hospital rate regulation (the New York Prospective Hospital Reimbursement Methodology [NYPHRM]) as a policy tool to achieve three objectives: containing costs, supporting financially stressed hospitals, and financing access to care for the uninsured. This case study of NYPHRM suggests that the regulatory approach, if pursued with vigor, can achieve any one of these goals. On the other hand, the New York experience also shows that these are competing goals, and that achieving all of them over a period of time can prove to be difficult.
Fraser
I
I
Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
D000553:Ambulatory Care / Q000706:statistics & numerical data / Q000639:trends; D054598:Blue Cross Blue Shield Insurance Plans / Q000331:legislation & jurisprudence; D003363:Cost Control; D005377:Financial Management, Hospital / Q000331:legislation & jurisprudence*; D006292:Health Priorities; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D008484:Medicaid / Q000331:legislation & jurisprudence; D009518:New York; D015397:Program Evaluation; D011445:Prospective Payment System / Q000331:legislation & jurisprudence*; D011787:Quality of Health Care / Q000191:economics; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence*; D013221:State Health Plans / Q000191:economics* / Q000331:legislation & jurisprudence; D014481:United States