Lerner W M, Wellman W L
Hosp Health Serv Adm. 1985 Jan-Feb;30(1):7-28.
Traditionally, pricing of hospital-based ancillary and diagnostic services has been a reactionary response to a cost-based budgeting system. Revenue objectives have been determined by budgeted costs, new development, contractual allowances, and required net income. Since hospitals have found it difficult to accurately measure the costs of specific services, price setting has been reserved solely for senior management or for the financial division. Thus, operating managers and their professional (medico-administrative) counterparts have had little opportunity to participate in the price-setting process and, for the most part, have had little understanding of the cost components which should be analyzed before the rates are set. A great deal of confusion and questioning has developed surrounding the establishment of prices at the departmental level. Although hospitals have given some consideration to market forces, this element in the new competitive environment will have a greater impact on the services purchased by the various payors.
传统上，医院辅助和诊断服务的定价一直是对基于成本的预算系统的一种被动反应。收入目标由预算成本、新业务发展、合同补贴和所需净收入决定。由于医院发现难以准确衡量特定服务的成本，定价工作一直仅由高级管理层或财务部门负责。因此，运营经理及其专业（医疗管理）同行几乎没有机会参与定价过程，而且在很大程度上，他们对定价前应分析的成本构成了解甚少。围绕部门层面的定价已经产生了大量的困惑和质疑。尽管医院已经对市场力量有所考虑，但在新的竞争环境中，这一因素将对各付款方购买的服务产生更大影响。
