Table 1. State Legislated Hospital Cost-Containment Programs.

	Responsible Agency	Type of System	Voluntary Mandatory	Payers Covered	Revenue Control Method	Unit of Payment	Frequency of Review	Adjustments	Appeals
Arizona	Department of Health Services, local HSAs	budget/rate review	mandatory review, voluntary compliance	charge-based, including Blue Cross	total revenue	charges	prior to any rate change	not applicable	not applicable
California	California Health Facilities Commission	disclosure	mandatory disclosure	not applicable	not applicable	not applicable	annually	not applicable	not applicable
Connecticut	Commission on Hospitals and Health Care	budget/rate review and approval	mandatory	charge-based	total revenue	charges	annually	inflation, volume, unforeseen and material change in expense	public hearing before Commission
Florida	Hospital Cost-Containment Board, State Insurance Department	disclosure/rate review	mandatory disclosure, voluntary compliance	not applicable	not applicable	not applicable	annual disclosure; rate reviews as necessary	not applicable	not applicable
Illinois	Illinois Health Finance Authority	budget/rate review and approval	mandatory	all payers	total revenue	charges	annually and as necessary	inflation, volume, cost beyond control	public hearing before Authority
Maine	Health Facilities Cost Review Board: Voluntary Budget Review Organization	budget/rate review	mandatory review, voluntary compliance	charge-based	total revenue	charges	annually	not applicable	not applicable
Maryland	Health Services Cost Review Commission	budget/rate review and approval	mandatory	all payers	Total revenue, departmental revenue, guaranteed revenue per case	charges	as necessary	inflation, volume, cost beyond control	public hearing before Commission
Massachusetts	Massachusetts Rate-Setting Commission	budget/rate review and approval	mandatory	charge-based	total revenue with cost limit	charges	annually	inflation, volume, cost beyond control	Division of Hearing Officers
		contract/cost/rate review and approval	mandatory	Blue Cross	cost-based	percent of approved budget	annually	Excess costs may be denied.	courts
		Modified formula base	mandatory	Medicaid	cost-based with limits	per diem	annually	uncontrollable costs associated with change in government regulations	Division of Hearing Officers
Minnesota	Department of Health; Minnesota Hospital Association	budget/rate review	mandatory review, voluntary compliance	charge-based, including Blue Cross	total revenue	charges	annually and when requested during year	inflation, volume	Department of Health public hearing before independent hearing examiner; Minnesota Hospital Association-hearing before appeals panel
New Jersey	State Department of Health; New Jersey Hospital Rate-Setting Commission	budget/rate review and approval	mandatory	all payers	total revenue	rate per case and controlled charges	annually and when requested during the year	retroactive for volume, economic factor, pass-through items	formal appeal before Commission
New York	State Department of Health	rate setting	mandatory	Medicaid and Blue Cross	cost-based	per diem	annually	retroactive for actual economic factor and volume	Formal appeal before State hearing officer
		charge control	mandatory	charge-based	charge increase	charges	as necessary	Actual economic factor	Appeals Board
Oregon	State Health Planning and Development Agency	budget rate review	mandatory review, voluntary compliance	charge-based, including Blue Cross	total revenue	charges	annually and when requested during year	not applicable	not applicable
Rhode Island	State Budget Office; Blue Cross of Rhode Island	negotiated budget/rate review and approval	mandatory	Medicaid and Blue Cross	Total expenses/revenue	percent of charges	annually	retroactive volume	binding arbitration before independent mediation
Virginia	Virginia Health Services Cost Review Commission; voluntary cost review organization	budget/rate review	mandatory review, voluntary compliance	charge-based	departmental revenue	charges	annually and when requested	not applicable	not applicable
Washington	Washington State Hospital Commission	budget/rate review and approval	mandatory	charge-based, including Blue Cross	Total revenue; rates per unit of service by revenue center	charges	annually	volume	Formal hearing before Commission or independent hearing officer
West Virginia	Department of Health	disclosure/rate review	mandatory disclosure, voluntary compliance	not applicable	not applicable	not applicable	annual disclosure; rate reviews as necessary	not applicable	not applicable
Wisconsin	State Department of Health, Rate Review Committee	budget/rate review and approval	mandatory	charge-based, including Blue Cross	total revenue	charges	prior to any rate change, usually limited to one per year	none	Hearing before independent appeals board