Hospital collective bargaining: structure and process.

The increasing influence of third parties on collective bargaining has continued to interest labor relations practitioners. The authors discusses the role of third-party payers and state regulatory agencies in labor-management negotiations at voluntary hospitals. Highlighted is the bargaining strategy adopted by negotiators when collective bargaining operates under a prospective rate-setting system. Also presented are the economic variables by which the payers influence hospital-union relationships and their effect on the outcomes of bargaining. The author describes the political context of health-care bargaining and the growing significance of cost control on hospital negotiations. He concludes that third-party payers cause health-care bargaining to change from a bilateral structure to a multilateral dimension.