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Institutional Responses to Prospective Payment Based on Diagnosis-Related Groups

1985; Massachusetts Medical Society; Volume: 312; Issue: 10 Linguagem: Inglês

10.1056/nejm198503073121005

1533-4406

Robert S. Stern, Arnold M. Epstein,

Primary Care and Health Outcomes

OVER the next three years, cost-based reimbursement for hospital services rendered to Medicare recipients will be eliminated.1 Medicare's decision to adopt instead a prospective payment system based on diagnosis-related groups (DRGs) represents a potential revolution in the nation's health care delivery system. Under the new system, hospitals will be paid on a per case basis with fixed payment for each of 467 DRGs.Proponents of the DRG system believe that it will solve many of the ills now attributed to cost-based reimbursement. In his report to Congress, former Secretary of Health and Human Services Richard Schweiker suggested that a DRG-based . . .