Medicare payment policy: does cost shifting matter?
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.
Lee
Jason S
JS
National Organization for Research at Chicago, Washington, DC, USA. Lee-Jason@norc.net
Berenson
Robert A
RA
Mayes
Rick
R
Gauthier
Anne K
AK
D002017:Budgets; D003361:Cost Allocation; D006291:Health Policy; D017721:Hospital Costs / Q000639:trends; D006278:Medicare / Q000191:economics*; D012051:Reimbursement Mechanisms; D014481:United States