Johnson A N, Madson R A, Aquilina D
J Health Polit Policy Law. 1984 Summer;9(2):251-67. doi: 10.1215/03616878-9-2-251.
Cost-shifting, the practice by hospitals of raising their prices to make up for reimbursement shortfalls from payers that do not pay full charges, is an important and controversial issue. Concerns about cost-shifting, particularly its effects on payment equity and cost escalation, have led many insurers, business groups, and legislators to advocate rate-setting regulation for hospitals. This article seeks to clarify the definition of cost-shifting, and quantifies its magnitude in Minneapolis/St. Paul. We believe that cost-shifting is the consequential result of the failure of both public and private payers to structure payment policies that reward cost-effective hospitals, and we outline a market-oriented alternative to rate-setting to address the discount dilemma caused by cost-shifting.
成本转嫁，即医院提高价格以弥补未全额支付费用的付款方报销缺口的做法，是一个重要且有争议的问题。对成本转嫁的担忧，尤其是其对支付公平性和成本上升的影响，促使许多保险公司、商业团体和立法者主张对医院进行费率设定监管。本文旨在明确成本转嫁的定义，并量化其在明尼阿波利斯/圣保罗的规模。我们认为，成本转嫁是公共和私人付款方未能构建奖励成本效益高的医院的支付政策的必然结果，并且我们概述了一种替代费率设定的市场化方法，以解决成本转嫁导致的折扣困境。
