Table 1. Characteristics Determining Program Scope and Stringency.

Program	Extent of Authority	Payers Covered	Scope of Analysis During Review	Compliance Mechanisms	Coordination with Planning Program
Arizona	Least extensive	Blue Cross Commercial insurers Self pay	Subjective review	Voluntary (public disclosure)	Informal
Connecticut	Moderate	Commercial insurers Self pay	Sequential screens applied to budget, clusters of departments, and departments	Mandatory	Formal
Maryland	Extensive	All payers	Department-level screens and adjustments	Mandatory (cumulative)	Counter
Massachusetts Medicaid	Extensive	Medicaid	Formula-based adjustments of past adjusted expenses	Mandatory (cumulative)	Informal
Charge-control3	Moderate	Commercial insurers Self pay	Review of overall budget	Mandatory But limited	Informal
Minnesota	Moderate	Blue Cross Commercial insurers Self pay	Screens applied to selected functional categories	Mandatory	Minimal
New Jersey	Extensive	Medicaid Blue Cross	Sequential screens applied to departmental clusters, then individual departments	Mandatory (cumulative)	Formal
New York	Most extensive	Medicaid Blue Cross Commercial insurers Self pay	Screens applied to routine expenses per day and ancillary expenses per admission	Mandatory	Formal
Western Pennsylvania	Moderate	Blue Cross Medicare Medicaid	Screens applied to overall expenses and subjective analysis used for departmental costs	Mandatory	Minimal
Washington	Extensive	All payers	Sequential screens applied to overall unit costs, natural expense categories, and departments	Mandatory	Formal

¹Characterization based on program's ranking within various dimensions of authority, as indentified in the First Annual Report of the National Hospital Rate Setting Study (Hamilton and Walter, 1980).

²Types of coordination are defined as follows: formal Involves well-defined, structured planning-regulatory interaction; Informal involves less structured interagency contact and sharing of data and other input; counter coordination occurs when the two groups frequently work at cross purposes; and minimal coordination occurs when virtually no linkages exist.

³Term refers to charge paying individuals or agencies.