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Review
. 1993 Spring;14(3):183-225.

Effects of selected cost-containment efforts: 1971-1993

M Gold  1 , K Chu, S Felt, M Harrington, T Lake
Affiliations
Review

Effects of selected cost-containment efforts: 1971-1993

M Gold et al. Health Care Financ Rev. 1993 Spring.
No abstract available

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Figures

Figure 1
Figure 1. Trends in Annual increases in Total Hospital Expenses Before, During, and After the Economic Stabilization Program (ESP): 1969-77
Figure 2
Figure 2. Trends in Annual Increases in Total Hospital Expenses Before, During, and After the Voluntary Effort, in Response to Carter Hospital Cost-Containment Legislation: 1974-82
Figure 3
Figure 3. Annual Percent Change in Real National and Medicare Hospital per Capita Expenditures: 1970-91
Figure 4
Figure 4. Annual Percent Change in Real National and Medicare Physician per Capita Expenditures: 1970-91
Figure 5
Figure 5. Maryland Cost per Admission as a Percent of U.S. Cost per Admission: 1976-92
See this image and copyright information in PMC

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References

Appendix: Selected Annotated References by Topic for Each of the Five Cost-Containment Efforts

Economic Stabilization Program
General Background and Effects
    1. Abernethy DS, Pearson DA. Regulating Hospital Costs: The Development of Public Policy. Ann Arbor, MI.: AUPHA Press; 1979.

    2. Overview and analysis of the 1977 Hospital Cost Containment Act and review of all the other cost-containment bills introduced in the same period in response to the administration's proposal. Examination of the actions of Congress and the opponents of the bills from the introduction of the bills to their defeat. Includes discussion of the Voluntary Effort.

    1. Altman SH, Eichenholz J. Inflation in the Health Industry: Causes and Cures. In: Zubkoff M, editor. Health: A Victim or Cause of Inflation? New York: PRODIST; 1977.

    2. Pre-ESP (Economic Stabilization Program) inflation, overall and in the health care sector. Basic structure of Phase II and its effects on hospital costs. Review of proposed Phase IV regulations for hospitals.

    1. Blinder AS, Newton WJ. The 1971-1974 Controls' Program and the Price Level: An Econometric Post Mortem. Journal of Monetary Economics. 1981;8:1–23.

    2. Empirical econometric study of the effects of wage-price controls on price levels. Reviews the theory of controls, basic features of the program, and empirical results on effects with a focus on non-food and non-energy prices.

    1. David K, Anderson GA, Rowland D, Steinberg EP. Health Care Cost Containment. Baltimore, MD.: Johns Hopkins University Press; 1990.

    2. General description of the structure and effects of ESP and review of other major cost-containment efforts from 1950 to 1990. Effectiveness in containing hospital costs; impact on the poor and uninsured; and impact on quality of care.

    1. Dunlop JT, Fedor KJ, editors. The Lessons of Wage and Price Controls—The Food Sector. Cambridge, MA.: Harvard University Press; 1977.

    2. Emphasis on the food sector but describes general effects of the ESP on the economy and political and administrative features of the program. John T. Dunlop was the Executive Director of the Cost of Living Council from the start of Phase III to the end of the program.

Regulations for Hospitals
    1. Altman SH, Eichenholz J. Inflation in the Health Industry: Causes and Cures. In: Zubkoff M, editor. Health: A Victim or Cause of Inflation? New York: PRODIST; 1977.

    2. Analysis of national data on average annual increases in hospital cost and revenue increases, 1950-75.

    1. Ginsburg PB. Impact of the Economic Stabilization Program on Hospitals: An Analysis with Aggregate Data. In: Zubkoff M, Raskin IE, Hanft RS, editors. Hospital Cost Containment: Selected Notes for Future Policy. New York: PRODIST; 1978.

    2. Multivariate analysis of quarterly national hospital data, 1963-73. Includes estimates of the effect of ESP on hospital wages, costs, input levels, and profit margins.

    1. Ginsburg PB. Inflation and the Economic Stabilization Program. In: Zubkoff M, editor. Health: A Victim or Cause of Inflation? New York: PRODIST; 1977.

    2. Conclusions of multivariate analysis [see previous reference] of the impact of ESP on hospital costs and input use.

    1. Raske KE. Hospitals Near Goal: Various Indicators Provide Ample Evidence That Hospitals Are Near the Overall Goal That the Economic Stabilization Program Set for Them. Journal of the American Hospital Association. 1973 Mar 16;47:45–50.

    2. Time series analysis by the hospital industry of the impact of ESP on hospital service charges, length-of-stay trends, occupancy rates, costs and wages.

    1. Sloan FA. Regulation and the Rising Cost of Hospital Care. The Review of Economics and Statistics. 1981 Nov;63:479–487.

    2. Multivariate analysis estimating the effect of numerous regulatory interventions, including ESP, on hospital costs.

Regulations for Physicians
    1. U.S. Congressional Budget Office. Rising Health Care Costs: Causes, Implications, and Strategies. Washington: U.S. Government Printing Office; 1991.

    2. Summary of key studies of physician fee controls and/or freezes, including ESP and the Medicare fee freeze.

    1. Hadley J, Holahan J, Scanlon W. Can Fee-For-Service Reimbursement Coexist with Demand Creation? Inquiry. 1979 Fall;16:247–258. - PubMed

    2. Theory of the nature of demand-inducement by physicians, with evidence from ESP's effect on physicians in California's Medicare program and evidence from Canada's universal health insurance system.

    1. Holahan J, Hadley J, Scanlon W, et al. Physician Pricing in California: Price Controls, Physician Fees, and Physicians' Incomes from Medicare and Medicaid. Washington, DC.: The Urban Institute; Sep, 1979. Report submitted to the Health Care Financing Administration.

    2. Results from study of ESP's effect on physician services and income in California's Medicare program.

    1. Starr P. The Social Transformation of American Medicine. New York: Basic Books; 1982.

    2. Brief note about ESP within the broader context of the history of health policy.

    1. Theodore CN, Warner JS. Physicians' Fees and the Source of Their Increase. In: Zubkoff M, editor. Health: A Victim or Cause of Inflation? New York: PRODIST; 1977.

    2. Factors influencing level and growth of physician fees and impact of ESP program on fee increases.

Related Articles on the Medicare Physician Fee Freeze
    1. Mitchell JB, Wedwig G, Cromwell J. The Physician Fee Freeze: What Really Happened. Health Affairs. 1989 Spring;8(1):21–33. - PubMed

    2. Multivariate analysis of effects of Medicare fee freeze on fee levels, and the volume, intensity, and distribution of services provided, using Medicare data from four States.

Carter-Era Hospital Cost Containment
    1. Abernethy DS, Pearson DA. Regulating Hospital Costs: The Development of Public Policy. Ann Arbor, MI.: AUPHA Press; 1979.

    2. Overview and analysis of the 1977 Hospital Cost Containment Act and review of all the other cost-containment bills introduced in the same period in response to the administration's proposal. Examines the actions of Congress and the opponents of the bills from the introduction of the bills to their defeat. Includes discussion of the Voluntary Effort.

    1. Appelbaum AL. Voluntary Effort Has Goal in Sight. Hospitals. 1979 Apr 16;:78–83. - PubMed

    2. Description of the Voluntary Effort from the industry's perspective.

    1. Davis K, Anderson GF, Rowland D, Steinberg EP. Health Care Cost Containment. Baltimore, MD.: Johns Hopkins University Press; 1990.

    2. Overview of the Hospital Cost Containment Acts of 1977 and 1979 and the Voluntary Effort.

    1. Dunn WL, Lefkowitz B. The Hospital Cost Containment Act of 1977: An Analysis of the Administration's Proposal. In: Zubkoff M, Raskin IE, Hanft RS, editors. Hospital Cost Containment. New York: PRODIST; 1978.

    2. In-depth analysis of the Hospital Cost Containment Act of 1977.

    1. Schaeffer DH. Voluntary Effort Best Approach to Cost Containment. Hospitals. 1979 Aug 1;:34–35. - PubMed

    2. Description of three voluntary targets for hospital expenses: the goal of the Voluntary Effort, the voluntary expenses target for hospitals incorporated into the President's anti-inflation program, and the voluntary target incorporated in the Hospital Cost Containment Act of 1979.

Medicare Hospital Prospective Payment System
Review of PPS Policy and Research
    1. Altman S, Young D. A Decade of Medicare's Prospective Payment System—Success or Failure? Journal of American Health Policy. 1993 Mar-Apr;3(2):11–19. - PubMed

    2. Review of the first 10 years of the Medicare prospective payment system [PPS], focusing on description of the program, major effects, and some lessons for health reform.

    1. Coulam R, Gaumer G. Medicare's Prospective Payment System: A Critical Appraisal. Health Care Financing Review. 1992 Mar;(1991 Annual Supplement):45–77. - PMC - PubMed

    2. Review of the research literature on the effects on PPS.

    1. Feinglass J, Holloway J. The Initial Impact of the Medicare Prospective Payment System on U.S. Health Care: A Review of the Literature. Medical Care Review. 1991 Spring;48(1):91–115. - PubMed

    2. Review of the research literature on the effects on PPS.

    1. Moon M. Medicare Now and In the Future. Washington, DC.: The Urban Institute Press; 1993.

    2. Discussion and analysis of the Medicare program.

    1. U.S. Congress, House Committee on Ways and Means. The Green Book: Overview of Entitlement Programs. Washington: U.S. Government Printing Office; 1992.

    2. Discussion of the technical aspects of PPS.

Research on PPS Effects on the Health Care System
    1. Prospective Payment Assessment Commission. Optional Hospital Payment Rate for Private Payers Based on Medicare's Methods (As Specified in HR 3626) Washington DC.: Mar, 1992a. Report C-92-03.

    2. Analyzes administrative issues involved in extending PPS to all payers and estimates the costs and effects of doing so.

    1. Prospective Payment Assessment Commission. Medicare and the American Health Care System. Washington DC.: Jun, 1992b. Report to Congress.

    2. Report on the effects of PPS on the health care system including hospitals, health care spending, and Medicare beneficiaries.

    1. Prospective Payment Assessment Commission. Medicare and the American Health Care System. Washington DC.: Jun, 1991. Report to Congress.

    2. Report on the effects of PPS on the health care system, including hospitals, health care spending, and Medicare beneficiaries.

    1. Russell L. Medicare's New Hospital Payment System: Is it Working? Washington, DC.: Brookings Institution; 1989. - PubMed

    2. Evidence and discussion of the effects of PPS on Medicare beneficiaries, the Medicare program, and the health care system.

    1. Russell L, Manning C. The Effect of Prospective Payment on Medicare Expenditures. New England Journal of Medicine. 1989 Feb 16;320(7):439–443. - PubMed

    2. Evidence of the savings for Medicare Part A spending resulting from PPS.

Research on Hospital Performance and Financial Status Under PPS
    1. Carter G, Newhouse J, Relles D. How much change in the case mix index is DRG creep? Journal of Health Economics. 1990;9(4):411–428. - PubMed

    2. Analysis of the components of change in case mix for hospitals under PPS.

    1. Feder J, Hadley J, Zuckerman S. How Did Medicare's Prospective Payment System Affect Hospitals? New England Journal of Medicine. 1987 Oct;317(14):867–873. - PubMed

    2. Initial experience of PPS hospitals compared with hospitals paid under Tax Equity and Fiscal Responsibility Act of 1982 [TEFRA] provisions.

    1. Guterman S, et al. Hospitals' Financial Performance in the First Five Years of PPS. Health Affairs. 1990 Spring;9(1):125–134. - PubMed

    2. Evidence of the effects of PPS on the health care system during the first 5 years of implementation.

    1. Hadley J, Zuckerman S, Feder J. Profits and Fiscal Pressure in the Prospective Payment System: Their Impacts on Hospitals. Inquiry. 1989 Fall;26(3):354–366. - PubMed

    2. Findings from analysis of the cost-containment effects of PPS on hospitals.

    1. Lillie-Blanton M, Felt S, Redmon P, et al. Rural and Urban Hospital Closures, 1985-1988: Operating and Environmental Characteristics that Affect Risk. Inquiry. 1992 Fall;29(3):332–344. - PubMed

    2. Evidence of the factors that lead to hospital closures, including discussion of PPS.

Research on PPS Effects on Non-Hospital Providers and Services
    1. Gianfrancesco F. Prospective Payment System and Other Effects on Post-Hospital Services. Health Care Financing Review. 1990 Winter;12(2):337–54. - PMC - PubMed

    2. Evidence of the effects of PPS and other factors on post-hospital services for Medicare.

    1. Helbing C, et al. Hospital Outpatient Services under Medicare, 1987. Health Care Financing Review. 1990 Summer;11(4):147–158. - PMC - PubMed

    2. Comparison of payments for outpatient services with payments for inpatient services during initial PPS years.

    1. Holahan J, Dor A, Zuckerman S. Has PPS Increased Medicare Expenditures on Physicians? Journal of Health Politics, Policy, and Law. 1991 Summer;16(2):335–362. - PubMed

    2. Evidence of the effects of PPS on physician expenditures.

    1. Kenney G. Understanding the Effects of PPS on Medicare Home Health Use. Inquiry. 1991 Summer;28(2):129–139. - PubMed

    2. Evidence of the effects of PPS on home care services.

Research on PPS Effects on Quality of Care
    1. DesHarnais S, Chesney J, Fleming S. Trends and Regional Variations in Hospital Utilization and Quality During the First Two Years of the Prospective Payment System. Inquiry. 1988 Fall;25(3):374–382. - PubMed

    2. Evidence from a study of PPS effects on quality of care for Medicare beneficiaries, with analysis of readmission rates, mortality rates, and utilization rates in the first 2 years of PPS.

    1. DesHarnais S, Kobrinski E, Chesney J, et al. The Early Effects of the Prospective Payment System on Inpatient Utilization and the Quality of Care. Inquiry. 1987 Spring;24(1):7–16. - PubMed

    2. Evidence from a study of PPS effects on quality of care for Medicare beneficiaries, with analysis of readmission rates, mortality rates, and utilization rates in the first year of PPS.

    1. Kahn K, Rogers W, Rubenstein L, et al. Measuring Quality of Care with Explicit Process Criteria Before and After Implementation of the DRG-Based Prospective Payment System. Journal of the American Medical Association. 1990 Oct 17;264(15):1969–1973. - PubMed

    2. Evidence from a study of PPS effects on quality of care for Medicare beneficiary disease groups, with focus on process of care.

    1. Kosecoff J, et al. Prospective Payment System and Impairment at Discharge: The ‘Quicker and Sicker’ Story Revisited. Journal of the American Medical Association. 1990 Oct 17;264(15):1980–1983. - PubMed

    2. Evidence from a study of PPS effects on quality of care for Medicare beneficiary disease groups, with focus on discharge outcomes.

Background Articles on Early Implementation of PPS
    1. Iglehart J. Medicare Begins Prospective Payment of Hospitals. New England Journal of Medicine. 1983 Jun 9;308(23):1428–1432. - PubMed

    2. Review of the legislative efforts to pass PPS.

    1. Iglehart J. The New Era of Prospective Payment for Hospitals. New England Journal of Medicine. 1982 Nov 11;307(20):1288–1292. - PubMed

    2. Review of the political, fiscal, and policy issues related to the period immediately preceding passage of PPS.

Medicare Physician Payment Reforms
Overview of Medicare Physician Payment Reforms
    1. Blumenthal D, Epstein A. Physician-Payment Reform—Unfinished Business. New England Journal of Medicine. 1992 May 14;326(20):1330–1334. - PubMed

    2. Overview of Medicare physician payment reform with a view toward the future of Medicare physician payment policy.

    1. Ginsburg P, LeRoy L, Hammons G. Medicare Physician Payment Reform. Health Affairs. 1990 Spring;9(1):178–192. - PubMed

    2. Summary of the provisions in the Omnibus Budget Reconciliation Act of 1989 mandating Medicare physician payment reform and discussion of implementation issues.

    1. Physician Payment Review Commission. Annual Report to Congress: 1993. Washington, DC.: 1993.

    2. Discussion and analysis of Medicare physician payment and its effects on the health care system, with emphasis on such topics as health system reform, the Medicare volume performance standard, and access to care for Medicaid beneficiaries.

    1. Physician Payment Review Commission. Annual Report to Congress: 1992. Washington, DC.: 1992.

    2. Discussion and analysis of Medicare physician payment and its effects on the health care system, with emphasis on such topics as health professional shortage areas, malpractice reform, and physician training.

    1. Physician Payment Review Commission. Annual Report to Congress: 1991. Washington, DC.: 1991.

    2. Discussion and analysis of Medicare physician payment and its effects on the health care system, with emphasis on such topics as fee schedules for other payers, payments for special types of providers, and options for Medicaid payment reform.

Simulated Effects of Medicare Physician Payment Reforms and Related Studies
    1. Christensen S. Volume Responses to Exogenous Changes in Medicare's Payment Policies. Health Services Research. 1992 Apr;27(1):65–79. - PMC - PubMed

    2. Analysis of changes in the volume of physician services associated with Medicare physician fee changes in Colorado in the 1970s.

    1. Ginsburg P, Hogan C. Letter to the editor. New England Journal of Medicine. To be published.

    2. (Responds to Hsiao et al. in New England Journal of Medicine, April 1993.

    1. Hsiao W, Braun P, Becker E, et al. Results and Impacts of the Resource-Based Relative Value Scale. Medical Care. 39(11) November 1992 Supplement:NS61–NS79. - PubMed

    2. Evidence of reform's effects on physician payments based on simulations using original resource-based relative value scale [RBRVS] model and model with the Health Care Financing Administration [HCFA] modifications.

    1. Hsiao W, Dunn D, Verrilli D. Assessing the Implementation of Physician-Payment Reform. New England Journal of Medicine. 1993 Apr;328(13):928–933. - PubMed

    2. Recent evidence of the effects of physician payment reform.

    1. Levy J, Borowitz M, McNeil S, et al. Understanding the Medicare Fee Schedule and its Impact on Physicians under the Final Rule. Medical Care. 39(11) November 1992 Supplement:NS80–NS893. - PubMed

    2. Evidence of reform's effects on physician payments based on simulations using the Medicare fee schedule implemented by HCFA.

International Comparisons
    1. Barer M, Evans R, Labelle R. Fee Controls as Cost Control: Tales from the Frozen North. Milbank Quarterly. 1988;66(1):1–64. - PubMed

    2. Discussion of cost containment through implementation of fee schedules with evidence from the Canadian system.

    1. Fuchs V, Hahn J. How Does Canada Do It? A Comparison of Expenditures for Physician's Services in the United States and Canada. New England Journal of Medicine. 1990 Sep 27;323(13):884–890. - PubMed

    2. Comparison of physician fees and the use of physician services by patients in the United States and Canada.

    1. Glaser W. How Expenditure Caps and Expenditure Targets Really Work. Milbank Quarterly. 1993;71(1):97–127. - PubMed

    2. Review of expenditure caps and expenditure targets in countries other than the United States, with lessons for U.S. health policy.

    1. Katz S, Zuckerman S, Welch WP. Comparing Physician Fee Schedules in Canada and the United States. Health Care Financing Review. 1992 Fall;14(1):141–149. - PMC - PubMed

    2. A comparison of physician payment in the United States and Canada.

Policy Context Preceding Medicare Physician Payment Reforms
    1. Iglehart JK. The New Law on Medicare's Payments to Physicians. New England Journal of Medicine. 1990 Apr 26;322(17):1247–1252. - PubMed

    2. Summary of Medicare physician payment reform legislation.

    1. Iglehart JK. The Recommendations of the Physician Payment Review Commission. New England Journal of Medicine. 1989 Apr 27;320(17):1156–1160. - PubMed

    2. Summary of the recommendations of the Physician Payment Review Commission [PPRC] in spring 1989 for Medicare physician payment reform.

    1. Ginsburg P. Physician Payment Policy in the 101st Congress. Health Affairs. 1989 Spring;8(1):6–20. - PubMed

    2. Discussion of the political, fiscal, and policy context immediately preceding passage of Medicare payment reform.

    1. U.S. Congressional Budget Office. Physician Reimbursement Under Medicare: Options for Change. Washington: U.S. Government Printing Office; Apr, 1986.

    2. Discussion of options for reforming Medicare physician payment in the policy context preceding passage of reforms.

State Hospital Ratesetting Programs
Summary Reviews
    1. Anderson GF. All-Payer Ratesetting Down But Not Out. Health Care Financing Review. 1992 Mar;(1991 Annual Supplement):35–41. - PubMed

    2. Review of the literature covering the impacts of ratesetting on costs, cost shifting, caring for the uninsured, quality of care, stifling of competitive alternatives, slowed diffusion of technology, and gaming the system.

    1. Davis K, et al. Health Care Cost Containment. Baltimore, MD.: Johns Hopkins University Press; 1990. The Experience of State Rate-Setting Agencies in Health Care Cost Containment.

    2. Literature review, including overview of State program features, goals, and impacts.

    1. Dowling WL. Prospective Reimbursement of Hospitals. Inquiry. 1974 Sep;11(3):163–180. - PubMed

    2. Discusses issues in designing prospective payment systems and describes key features of the ratesetting programs in place in the early 1970s.

    1. Eby CK, Cohodes DR. What Do We Know About Rate-Setting? Journal of Health Politics, Policy and Law. 1985 Summer;10(2):299–327. - PubMed

    2. Review of the literature of 1979-84; 17 empirical studies with a variety of methodologies are reviewed for what is known, what is not known, and implications.

    1. Esposito A, Hupfer M, Mason C, Rogler D. Abstracts of State Legislated Hospital Cost-Containment Programs. Health Care Financing Review. 1982 Dec;4(2):129–183. - PMC - PubMed

    2. Summary of 17 States' programs requiring the disclosure, review, or regulation of hospital rates or budgets, as of May 1982.

Empirical Studies: Multiple States, Impacts on Cost, Utilization, Providers, and Access
    1. Biles B, Schramm C, Atkinson G. Hospital Cost Inflation Under State Rate-Setting Programs. New England Journal of Medicine. 1980 Sep 18;303:664–668. - PubMed

    2. Empirical study analyzing trends in expense per equivalent admission [accounts for hospital outpatient as well as inpatient activity] during 1970-78 in 6 ratesetting and 44 non-ratesetting States.

    1. Hadley J, Swartz K. The Impacts on Hospital Costs between 1980 and 1984 of Hospital Rate Regulation, Competition, and Changes in Health Insurance Coverage. Inquiry. 1989 Spring;26(1):35–47. - PubMed

    2. Empirical [multivariate] analysis of factors affecting rates of increase in hospital expenses in 43 large standard metropolitan statistical areas between 1980 and 1984.

    1. Morrisey MA, Sloan FA, Mitchell SA. State Rate Setting: An Analysis of Some Unresolved Issues. Health Affairs. 1983 Summer;2(2):36–47. - PubMed

    2. Empirical study [multivariate] of ratesetting impacts on hospital per admission, per day, and per capita costs and on hospital profit margins during 1968-81.

    1. Robinson JC, Luft HS. Competition, Regulation, and Hospital Costs, 1982 to 1986. Journal of the American Medical Association. 1988 Nov 11;260(18):2676–2681. - PubMed

    2. Empirical analysis [multivariate] of the relative effectiveness of all-payer rate regulation programs in New York, New Jersey, Massachusetts, and Maryland; California's market-oriented cost-control strategies; and Medicare's prospective payment system on reducing the rate of inflation in average hospital costs per admission for 1982-86.

    1. Romeo AA, Wagner JL, Lee RH. Prospective Reimbursement and the Diffusion of New Technologies in Hospitals. Journal of Health Economics. 1984 Apr;3(1):1–24. - PubMed

    2. Empirical study [multivariate] of the effects of prospective payment systems in New York, Maryland, and Indiana on diffusion of five “little-ticket” technologies.

Selected Papers and Reports from the National Hospital Ratesetting Study

    1. NOTE: The National Hospital Rate-Setting Study, funded by the Health Care Financing Administration, covered prospective reimbursement programs in 15 States during the period 1969-78.

    1. Coelen C, Sullivan D. An Analysis of the Effects of Prospective Reimbursement Programs on Hospital Expenditures. Health Care Financing Review. 1981 Winter;2(3):1–40. - PMC - PubMed
    1. Cromwell J, Kanak JR. The Effects of Prospective Reimbursement Programs on Hospital Adoption and Service Sharing. Health Care Financing Review. 1982 Dec;4(2):67–88. - PMC - PubMed
    1. Cromwell J, Hewes H. Medicare Expenditures and Utilization Under State Hospital Rate Setting. Chestnut Hill, MA.: Health Economics Research; Jun, 1984. - PMC - PubMed
    1. Kidder D, Sullivan D. Hospital Payroll Costs, Productivity, and Employment Under Prospective Reimbursement. Health Care Financing Review. 1982 Dec;4(2):89–100. - PMC - PubMed
Empirical Studies: Multiple States, Quality of Care
    1. Gaumer GK, Poggio E, Sennett C. Medicare Elective Surgery Outcomes and State Prospective Reimbursement Programs. Health Care Financing Review. (1987 Annual Supplement):17–27. - PMC - PubMed

    2. Empirical study of mortality rates for Medicare admissions for 8 elective procedures in 15 States with prospective reimbursement systems [including those normally included as rate-setting States], compared with nationwide rates during 1974-83.

    1. Gaumer GK, Poggio EL, Coelen CG, et al. Effects of State Prospective Reimbursement Programs on Hospital Mortality. Medical Care. 1989 Jul;27(7):724–736. - PubMed

    2. Empirical study of the 10-year trend in standardized mortality rates in hospitals located in 15 States with prospective reimbursement systems [including those normally included as rate-setting States], compared with those in a national sample of hospitals not under prospective reimbursement during 1974-83.

    1. Smith DW, McFall SL, Pine MB. State Rate Regulation and Inpatient Mortality Rates. Inquiry. 1993 Spring;39(1):23–33. - PubMed

    2. Empirical study of mortality rates in regulated and unregulated States, using the ratio of actual to estimated 30-day mortality rates and employing Medicare data for 1986.

Single-State Studies: Empirical or Descriptive
    1. Broyles RW. Efficiency, Costs, and Quality: The New Jersey Experience Revisited. Inquiry. 1990 Spring;27(1):89–96. - PubMed

    2. Empirical [multivariate] analysis of the relative effects of New Jersey's all-payer system and its partial-payer system on volume and cost during 1979-82, by hospital cost center [e.g., lab, radiology, nursing care].

    1. Hsiao WE, Sapolsky HM, Dunn DL, Weiner SL. Lessons of the New Jersey DRG Payment System. Health Affairs. 1986 Summer;5(2):32–45. - PubMed

    2. Empirical [tabular] analysis of the impact of diagnosis-related groups in New Jersey on costs, hospital financial condition, and provision of uncompensated care.

    1. Iglehart JK. New Jersey's Experiment with DRG-Based Hospital Reimbursement. New England Journal of Medicine. 1982 Dec 23;307(26):1655–1660. - PubMed

    2. Discussion of early implementation experience of diagnosis-related groups in New Jersey, drawing on views from key policymakers and other involved parties.

    1. Rosko MD. All-Payer Rate-Setting and the Provision of Hospital Care to the Uninsured: The New Jersey Experience. Journal of Health Politics, Policy and Law. 1990 Winter;15(4):815–831. - PubMed

    2. Empirical [multivariate] analysis of the effects of all-payer rate regulation on the volume of care provided to self-pay patients during 1979-85 in New Jersey hospitals.

    1. Rosko MD, Broyles RW. Short-Term Responses of Hospitals to the DRG Prospective Pricing Mechanism in New Jersey. Medical Care. 1987 Feb;25(2):88–89. - PubMed

    2. Empirical analysis [multivariate] of the short-term impact on cost and volume measures of New Jersey's diagnosis-related group (DRG)-based payment system implemented during 1980-82 [1975-82 data were used].

Articles Debating the Respective Merits or Effects of Ratesetting
    1. Buck CR, Gold M. Reviews: A State Department of Health. Health Affairs. 1982 Summer;1(3):119–123. - PubMed

    2. Reacts to Mitchell, 1982.

    1. Cohen HA. State Rate Setting Issues Reviewed. Letter to the Editor. Health Affairs. 1983 Winter;2(4):146–150. - PubMed

    2. Reacts to Morrisey et al., 1983.

    1. Cohen HA, Colmers JM. Reviews: A State Rate-Setting Commission. Health Affairs. 1982 Summer;1(3):99–108. - PubMed

    2. Reacts to Mitchell, 1982.

    1. Finkler M. State Rate Setting Revisited. Health Affairs. 1987 Winter;6(4):82–89. - PubMed

    2. Reacts critically to Schramm, Renn, and Biles, 1986.

    1. Mitchell SA. Issues, Evidence, and the Policymaker's Dilemma. Health Affairs. 1982 Summer;1(3):84–98. - PubMed

    2. Argues against ratesetting, drawing on anecdotal or case study evidence and tabular analysis.

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