Figure 1.

Aggregate Hospital Payment-to-Cost Ratios for Private Payers, Medicare, and Medicaid, 1980–2008.

Note: Medicaid includes Medicaid Disproportionate Share payments.

(A) = Beginning of Medicare Hospital Prospective Payment System (PPS) phase-in; (B) = PPS fully phased in; (C) = Era of commercial market managed care ascendance; (D) Balanced Budget Act (BBA) passage and managed care backlash.Source:AHA 2003, 2010.