Setting limits through global budgeting: hospital cost containment in Rhode Island

In 1974, hospitals in Rhode Island have participated in annual negotiations with state officials and representatives from Blue Cross to determine the allowed increase in statewide hospital costs (the "Maxicap") for the next fiscal year, based on projected increases in hospitals' revenues, changes in patient volume and operating expenses. Individual hospital budgets may be above or below the Maxicap as long as the total increase in hospital costs for all hospitals in the state does not exceed the negotiated amount. At a time when regulatory solutions are increasingly under fire, continued support for Rhode Island's approach to hospital cost containment from third party payers, providers and public officials stands in stark contrast to other states where rate setting was either dismantled or discredited as a cost control strategy. A negotiated global cap on hospital expenditures offers an alternative to formula-based state rate-setting methodologies which could be incorporated as part of an all-payer reimbursement methodology or as an incremental step towards more comprehensive reform.     

Reviews

David W. Lovell, From Marx to Lenin. An Evaluation of Marx's Responsibility for Soviet Authoritarianism. London: Cambridge University Press, 1984, xii + 231 pp. £19–50.

A. J. Polan, Lenin and the End of Politics. London: Methuen, 1984, vi + 229 pp. h/b £12–95, p/b £5–95.

David Lane, State and Politics in the USSR. Oxford: Basil Blackwell, 1985, xv + 398 pp. h/b £27–50 p/b £8.95. Soviet Economy and Society. Oxford: Basil Blackwell, 1985, xiii + 342 pp. h/b £27–50 p/b £8.95.

Curtis Keeble, ed., The Soviet State. The Domestic Roots of Soviet Foreign Policy, London: Gower, 1985, 244 pp. h/b £17.50 p/b 8.95.

Adam B. Ulam, Dangerous Relations: The Soviet Union in World Politics, 1970–1982. New York: Oxford University Press, 1983 vi + 325 pp., £5–95.

Gerald Segal, ed., The Soviet Union in East Asia: Predicaments of Power. London: Heinemann, 1983. x + 150 pp., h/b £14–50 p/b £6–50.

Bruce D. Porter, The USSR in Third World Conflicts: Soviet Arms and Diplomacy in Local Wars 1945–1980. Cambridge, London, New York, New Rochelle, Melbourne, Sydney: Cambridge University Press, 1984, viii + 248 pp., £20–00, $29.95.

Robert L. Pfaltzgraff, Jr., and Uri Ra'anan, eds., National Security Policy. The Decision‐making Process, Hamden, Conn.: Archon Books, 1984, xiv + 311 pp. £35.30.

Yosef Avidar, The Party and the Army in the Soviet Union. Jerusalem: The Magnes Press, The Hebrew University, 1983, 340 pp., h/b $25.00.

William Moskoff, Labour and Leisure in the Soviet Union: The Conflict Between Public and Private Decision‐Making in a Planned Economy. New York: St. Martin's Press, 1984, xv + 225 pp., £25.00.

Raymond Hutchings, The Soviet Budget. London and Basingstoke: Macmillan, 1983, x + 204 pp., £25.00.

Gary Littlejohn, A Sociology of the Soviet Union. London and Basingstoke: Macmillan, 1984, ix + 286 pp., h/b £18–00, p/b £6–95.

J. P. Cole, Geography of the Soviet Union. London: Butterworths, 1984, xiv + 452 pp., £14.95.

Robert G. Jensen, Theodore Shabad and Arthur W. Wright eds., Soviet Natural Resources in the World Economy. Chicago and London: University of Chicago Press, 1983, xix + 700 pp., £92.00.

Olympiad S. Ioffe and Peter B. Maggs, Soviet Law in Theory and Practice, London, Rome, New York: Oceana Publications, Inc., 1983, 237 pp., $35–00.

V. I. Smolyarchuk, Giganty i charodei slova. Russkie sudebnye oratory vtoroi poloviny XIX—nachala XX veka. Moscow, 1984, 272 pp., 65 kop.

Dina Kaminskaya, Final Judgement. My Life as a Soviet Defence Lawyer. London: Harvill Press, 1983, 364 pp., £12.95.

Dina Kaminskaya, Zapiski advokata. Vermont: Khronika Press, 1984, 345 pp., no price.

Gabriel Gorodetsky, Stafford Cripps’ Mission to Moscow 1940–42, Cambridge: the University Press, 1984, 377 pp., £25.00.

E. H. Carr (Edited by Tamara Deutscher), The Comintern and the Spanish Civil War. London: Macmillan, 1984, xx + 111pp., h/b £17–50, p/b £6.95.

David Mandel, The Petrograd Workers and the Fall of the Old Regime: From the February Revolution to the July Days 1917. London: Macmillan, (in association with the Centre for Russian and East European Studies, University of Birmingham), 1983, xii + 210 + 10 pp., £25.00.

David Mandel, The Petrograd Workers and the Soviet Seizure of Power: From the July Days 1917 to July 1918. London: Macmillan, (in association with the Centre for Russian and East European Studies, University of Birmingham), 1984, xv + 227 + 12 pp., £25.00.

Geoffrey Swain, Russian Social Democracy and the Legal Labour Movement, 1906–14. London: Macmillan, 1983, xiv + 239 pp., £25.00.

Benjamin Pinkus, The Soviet Government and the Jews 1948–1967. A Documented Study. Cambridge: Cambridge University Press, 1984, xvi + 612 pp., £35.00.

Jakub Blum and Vera Rich, The Image of the Jew in Soviet Literature: the Post‐Stalin Period. New York: Ktav Publishing House, Inc., 1984, 276 pp., No price quoted.

Yaacov Roi ed., The USSR and the Muslim World. London: George Allen and Unwin, 1984, xv + 298 pp., £25.00.

Michael Bruchis, Nations ‐ nationalities ‐ People: A Study of the nationalities policy of the Communist Party in Soviet Moldavia. Boulder Colorado: East European Monographs, distributed by Columbia University Press, New York, 1984, iv + 230 pp., No price quoted.

Michael J. Sodaro and Sharon L. Wolchik eds., Foreign and Domestic Policy in Eastern Europe in the 1980s: Trends and Prospects. London: Macmillan, 1983, x + 265 pp., £25.00.

Adam Zwass, The Economies of Eastern Europe in a time of change. London: Macmillan, 1984, ix + 170 pp., £20.00.

R. Dietz, Die Energiewirtschaft in Osteuropa und der UdSSR. Vienna and New York: Springer‐Verlag, 1984, 248 pp., $17.90, DM 49.—.

Ferenc Feher and Agnes Heller, Hungary 1956 Revisited. The Message of a Revolution—a Quarter of a Century After. London: George Allen & Unwin, 1983, xviii + 174 pp., £15.00.

Ray Taras, Ideology in a Socialist State; Poland 1956–83. Melbourne: Cambridge University Press, 1984, x + 299 pp., £25.00.

Fred Singleton, A Short History of the Yugoslav Peoples, Cambridge: Cambridge University Press, 1985, xiii + 309 pp., h/b £22.50, p/b £7.50.

Martin McCauley, The German Democratic Republic since 1945. London: Macmillan, 1983, xiv + 282 pp., £25.00.

Raymond Bentley, Technological Change in the German Democratic Republic. Boulder, Colorado and London: Westview Press, 1984, xx + 296 pp., $25.00.

Paul‐Gunther Schmidt, Internationale Wahrungspolitik im sozialistischen Staat, Stuttgart, New York: Gustav Fischer Verlag, 1985, xii + 447 pp., DM 48.

R. H. Haigh, D. S. Morris, A. R. Peters, eds., German‐Soviet Relations in the Weimar Era. Aldershot: Gower, 1985, viii + 206 pp., £15.00.

Mireille Maqua, Rome‐Moscou, l'Ostpolitik du Vatican, Liège: Cabay publishers, 1985, 248 pp., 580 F.B.

Ian Nish, The Origins of the Russo‐Japanese War, (Origins of Modern Wars Series: General Editor, Harry Hearder), Longman, London and New York, 1985. xiii + 274 pp. £6.95 paper.