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The Cost-Shift Payment Hydraulic: Foundation, History, And Implications
Allen Dobson,
Joan DaVanzo and
Namrata Sen
The cost-shift payment "hydraulic" is an integral component of the fragmented U.S. health care financing system. If private payers acceptance of the cost-shifting burden were to erode, our system of health care financing could become unstable. This is especially true for the hospital industry. In this paper we provide a series of examples of cost shifting and a historical profile of the cost shift in the hospital industry since 1980, noting that cost-shifting pressures seem to fluctuate over time and across health care markets. Cost shifting need not be dollar per dollar, as hospitals can absorb some degree of cost-shifting pressure through increased efficiency and decreases in service provision.

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Comments:
Read all Comments
- Why Private Payers Accept Cost Shifting
- John Grima
- Health Affairs, 11 Jan 2006
[Full text]
- Re: Why Private Payers Accept Cost Shifting
- Gerald Gruber
- Health Affairs, 22 Oct 2009
[Full text]
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