Medicare payment policy: does cost shifting matter?
Medicare payment policy: does cost shifting matter?
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医疗保险支付政策：成本转移重要吗？
DOI：
10.1377/hlthaff.w3.480
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发表时间：
2003
期刊：
影响因子：
9.7
通讯作者：
A. Gauthier
中科院分区：
文献类型：
--
作者：
Jason S. Lee;R. Berenson;R. Mayes;A. Gauthier
我们在医疗保险支付政策的背景下研究成本转移。我们简要回顾了经济理论和现有数据，并讨论了政策成本转移的重要性。然后，我们提出了四个核心调查结果的基础上，前高层决策者的观点的成本转移。首先，医疗保险的早期（预先预期）支付政策对医院来说是一个布恩。其次，医疗保险支付政策是一个“自上而下”的事务，由预算和特殊利益政治驱动。第三，联邦政策制定者可能不会有意识地考虑成本转移，但州政策制定者会。第四，医疗保险支付政策需要不断调整，但我们大多数时候都在“做对”。
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.