1. Cost shifting occurs when a provider responds to low reimbursement rates by public payers (e.g., Medicare or Medicaid) or uncompensated care provided to the uninsured by charging private payers—insurers, managed care companies, or private individuals—more. Essentially, hospitals and physicians try to compensate for providing care below costs to some patients by raising their charges to others. To be able to do so, they would have had to not be fully exploiting their market power in the first place. What is a classic example of this in the healthcare marketplace and how would you go about developing a remedy to reduce the unfair burden cost shifting places on certain payers?

1. Cost shifting occurs when a provider responds to low reimbursement rates by public payers (e.g., Medicare or Medicaid) or uncompensated care provided to the uninsured by charging private payers—insurers, managed care companies, or private individuals—more. Essentially, hospitals and physicians try to compensate for providing care below costs to some patients by raising their charges to others. To be able to do so, they would have had to not be fully exploiting their market power in the first place. What is a classic example of this in the healthcare marketplace and how would you go about developing a remedy to reduce the unfair burden cost shifting places on certain payers?

Personal Finance

13th Edition

ISBN:9781337669214

Author:GARMAN

Publisher:GARMAN

Chapter11: Planning For Health Care Expenses

Section11.2: Types Of Health Care Plans

Problem 1CC

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