NH Public Policy
New Hampshire Center for Public Policy Studies

Health System Cost-Shifting in New Hampshire

Executive Summary

Date: March 13th, 2011

The Center examines the health industry practice known as "cost-shifting"–charging certain patient populations more than the actual cost of their care so as to cover the cost of providing treatment to uninsured patients or Medicare and Medicaid patients whose expenses are not completely covered by the government.

For policy makers interested in limiting cost-shifting, the report presents three possible policy responses:

  • Encouraging the health care system to lower the cost of services so that existing reimbursement levels are adequate.
  • Expanding health insurance coverage so that charitable care is financed by a source other than cost-shifting.
  • Encouraging both the state Medicaid program and the federal Medicare program to increase reimbursements.

Any of these changes could significantly reduce the cost-shifting phenomenon–and theoretically reduce premiums for private payers. However, the costs of these policy options–specifically expansions in coverage and increases in reimbursement levels–would have to be borne by either the state or federal government.

Report File