what is cost shifting in relation to the pricing of health care products and services? course hero

by Breana Welch 9 min read

Cost shifting occurs when a hospital or other health-care provider charges an insured patient more than it does an uninsured patient for the same procedure or service. Those with health insurance, in effect, pay for the financial loss hospitals incur when they provide services to those without insurance.

Full Answer

What is cost shifting in healthcare?

Rather, cost shifting exists when the prices faced by one group of payers are higher because another group pays less. To be able to cost shift, a hospital must have market power, and it must not yet have fully exercised that power. There has been a spate of recent cost-shifting studies.

Does the market limit the extent of cost shifting?

Thus, the extent of cost shifting is limited by the market. Cost shifting is not as easy as it may have been in the past because the nature of hospital and insurer competition has changed radically in the last decade. While hospital quality, services, and amenities still matter, some buyers are increasingly concerned about the price they pay.

Do hospitals set different prices for different payers?

The issue of cost shifting has taken on enormous policy implications. It is estimated that unsponsored and undercompensated hospital costs--one measure of cost shifting--has totaled $21.5 billion in 1991. The health services research literature indicates that hospitals set different prices for different payers.

How does market power affect hospital prices?

When a hospital has market power, it is able to set prices above marginal costs. However, when a buyer has enough patient/subscribers and a willingness to direct them to particular providers based on price considerations, hospitals have less flexibility in raising prices above costs. Thus, the extent of cost shifting is limited by the market.

What does cost shifting mean in healthcare?

Cost shifting implies that privately insured patients pay part of the cost of care for publicly insured and uninsured patients, implying that the extent of redistribution in the US health system is much greater than tax-based analyses alone would suggest. 1.

How does cost shifting affect health care?

Cost shifting occurs when a hospital or other health-care provider charges an insured patient more than it does an uninsured patient for the same procedure or service. Those with health insurance, in effect, pay for the financial loss hospitals incur when they provide services to those without insurance.

What is the concept of cost shifting?

Cost shifting is commonly defined as “the practice by a hospital of charging more to one group of patients because another group is not paying its share.” 1 However, it is more accurate to state that cost shifting occurs when a hospital must increase prices charged to all payers to make up for shortfalls in ...

Is there a relationship between cost and price in healthcare?

Recent studies have shown that there is no relation between cost and quality when it comes to our healthcare. And by becoming aware of this fact sooner, you are likely to save hundreds or thousands of dollars on your medical expenses each year.

What are the benefits of cost shifting?

Increased transparency about employers' and employees' health care costs and savings. Shared savings rebates to limit cost shifting to employees. Reducing employees' cost-sharing burdens by expanding the ACA's free preventive-services benefit.

What factors affect hospitals ability to practice cost shifting?

Cost shifting is possible if hospitals have underexploited their market power. Measures of public and private payer volume (or one relative to the other) are related to cost-shifting behavior. Hospitals do not maximize profit. Both cost shifting and cost cutting are expected responses due to public payment reductions.

What is an example of cost shifting?

Cost shifting is a situation in which people may pay for the same goods or services at different prices. One of the biggest known examples is in the US healthcare system. Few causes could be that in the USA the health insurance is not obligatory, or there exist more systems of insurance.

How does cost shifting differ from price discrimination?

Cost shifting implies price discrimination but the existence of price discrimination does not imply cost shifting has occurred or, if it has, at what rate (i.e. how much did one payer's price change relative to that paid by another). That hospitals shift their costs among payers is intuitively appealing.

Is there price discrimination in healthcare?

Price discrimination can occur in healthcare, where the prices consumers pay for identical services are contingent upon their ability to pay or the discretion of the healthcare practitioner.

Why is cost associated with health care?

Americans spend a huge amount on healthcare every year, and the cost keeps rising. In part, this increase is due to government policy and the inception of national programs like Medicare and Medicaid. There are also short-term factors, such as the 2020 financial crisis, that push up the cost of health insurance.

What is the difference between costs and charges in health care?

Charge is the dollar amount a health care provider sets for services rendered before negotiating any discounts. The charge can be different from the amount paid. Cost varies by the party incurring the expense. To the patient, cost is the amount payable out-of-pocket for healthcare services.

What are the three definitions of health care costs?

Health care costs refer to staffing (salary + benefits), equipment, supplies, and capital. The three meanings of cost are (1) money to produce health care services (2) population-level spending (3) cost of spending.

Why is cost shifting not easy?

Cost shifting is not as easy as it may have been in the past because the nature of hospital and insurer competition has changed radically in the last decade. While hospital quality, services, and amenities still matter, some buyers are increasingly concerned about the price they pay.

How much did hospitals cost in 1991?

It is estimated that unsponsored and undercompensated hospital costs--one measure of cost shifting--has totaled $21.5 billion in 1991. The health services research literature indicates that hospitals set different prices for different payers. However, the empirical evidence on hospitals' ability to raise prices to one payer to make up ...

What is market based pricing?

In a competitive market, a hospital that traditionally cared for the uninsured by spending some of its profits on them will be unable to do so, at least to the same extent as it did in the past.