Multilateral health care negotiations: the shadow at the bargaining table

Third-party payers and state regulatory agencies play a major role in health care negotiations. Third-party payer impact arises because of the significant amount of revenue provided to health institutions by these revenue sources. This article reviews the process by which third-party payers and state regulatory agencies affect health care negotiations and the outcomes experienced under these arrangements. The author describes the multilaterial bargaining structure of health care negotiations and illustrates this relationship through recent hospital bargaining in New York City.