What triggered the downsizing phase in the u. s. hospital industry during the 1980s?

It was triggered by the Prospective Payment System or PPS. It is a way of compensation in which medicare payment is made based on a prearranged or fixed amount. The payment total for a specific service is resulting in the classification system of that examination or service.

Ithink it is a i’m not sure.

(c) spain left the philippines to the usa