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All-payer ratesetting: down but not out.
1Johns Hopkins Center for Hospital Finance and Management, Baltimore, MD 21205.
Health Care Financing Review. Annual Supplement
|December 10, 1990
Summary
All-payer hospital ratesetting effectively achieves cost containment and improves access for the uninsured. This system does not hinder healthcare competition or technological advancement, with minimal impact on care quality.
Area of Science:
- Health Economics
- Healthcare Policy
- Public Health
Background:
- The U.S. healthcare system shifted from regulation to competition, leading to the decline of all-payer hospital ratesetting.
- Previous literature on all-payer ratesetting needs updating with current data.
Purpose of the Study:
- To evaluate the effectiveness of all-payer hospital ratesetting in meeting its objectives.
- To assess the impact of all-payer ratesetting on healthcare competition, technology, and quality of care.
Main Methods:
- Comprehensive review of published literature.
- Supplementation of existing literature with current data.
Main Results:
- All-payer ratesetting successfully achieves cost containment and reduces cost shifting.
- It improves access to care for the uninsured and enhances hospital productivity.
- No significant negative impact was observed on competitive healthcare systems, technology diffusion, length of stay, admissions, or quality of care.
Conclusions:
- All-payer hospital ratesetting is a viable policy for achieving multiple healthcare objectives.
- The system demonstrates effectiveness without stifling innovation or negatively impacting key healthcare metrics.