ABSTRACT
Since the onset of Medicare in 1965, there has been an almost continuous call and need for reform. Payments from the federal government to providers grew at alarming rates from the very beginning and have contributed to an unsustainable growth rate in the healthcare market since that time. Physicians were paid on a fee-for-service basis and hospitals were reimbursed at whatever cost they incurred, with little oversight or uniformity among hospitals. Blue Cross was also used as an intermediary to receive billing and to make payments on behalf of Medicare. Standard Hospital Accounting & Rate Evaluation (SHARE) began as a modest attempt to rationalize hospital payments, only regulating Medicare and Blue Cross initially. As hospitals in New Jersey began receiving less payments through Medicare and Blue Cross, they began shifting payments to insurers not regulated as a part of SHARE.
