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Juggling multiple payers: American problems and foreign solutions.

W A Glaser

    Inquiry : a Journal of Medical Care Organization, Provision and Financing
    |January 1, 1984
    PubMed
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    American hospitals face financial disarray due to numerous payers, unlike more stable, single-payer systems abroad. This complexity hinders financial management and innovation in US healthcare.

    Area of Science:

    • Health Economics
    • Healthcare Management
    • Comparative Health Systems

    Background:

    • The US healthcare system's financial structure is characterized by a multitude of payers and complex cost-shifting strategies among them.
    • This fragmentation contrasts sharply with systems in other developed nations, where payer cooperation or consolidation is common.

    Purpose of the Study:

    • To analyze the impact of diverse payer systems on hospital financial stability.
    • To compare financial management practices in US hospitals with those in other developed countries.
    • To explore the relationship between payer consolidation and hospital innovation.

    Main Methods:

    • Comparative analysis of hospital financial structures and payer systems across developed countries.
    • Review of financial management strategies employed by US hospitals.

    Related Experiment Videos

  • Examination of trends in payer consolidation and its effects on healthcare systems.

    • Main Results:

    • The multiplicity and varied methods of payers are primary drivers of financial instability in American hospitals.
    • Hospitals in countries with consolidated or cooperative payment systems exhibit greater financial stability.
    • International models include merged third parties, standardized budget calculations across payers, and centralized financial administration.
    • A trend towards single-source payment concentration is observed globally.

    Conclusions:

    • Consolidated payment systems contribute to greater financial stability in hospitals compared to fragmented US payer models.
    • While international models offer stability, they may also present challenges to risk-taking, innovation, and the acceptance of failure in healthcare.