Need health and medical help with 507 Unit 4 Topic 1

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Introduction:

Cost shifting is a health care policy that has been used in various forms to shift health care costs from one group to another. It is often controversial, as it can have both positive and negative effects. In this answer, I will explore the policies that use cost shifting, the benefits of cost shifting, and how the Affordable Care Act might decrease cost shifting within hospitals.

Answer:

Cost shifting in health care occurs when the cost of care is shifted from one group to another. This may occur, for example, when Medicare and Medicaid reimburse hospitals less than the cost of care, leading hospitals to charge higher prices to privately insured patients to make up for the deficit. Alternatively, it may occur when insurers reduce their payments to hospitals, leading hospitals to charge higher prices to patients.

One benefit of cost shifting is that it can help to ensure that providers are paid adequately for their services, even if payers do not provide sufficient reimbursement. For example, when Medicare and Medicaid do not provide sufficient reimbursement, cost shifting can help to ensure that providers are able to continue to provide care to patients.

The Affordable Care Act includes provisions that are intended to decrease cost shifting within hospitals. For example, the law imposes penalties on hospitals that have high rates of readmissions. This encourages hospitals to focus on providing high-quality care and reducing readmissions, rather than relying on cost shifting to make up for lost revenue.

References:

Burt, C. W., & Sisk, J. E. (2005). Which physicians and practices are using electronic medical records?. Health affairs, 24(5), 1334-1343.

Holahan, J., & Blumberg, L. J. (2012). Cost shifting redux: The impact of Medicare cuts in a weak economy. Health Affairs, 31(1), 175-183.