Congress mandated diagnosis-related groups (DRG) as a method for recording costs in health care organizations, in part to facilitate Medicare's prospective payment system. Explain what the DRG system is and describe the impact this change may have had on the cost accounting systems of health care organizations.
What will be an ideal response?
Diagnosis-related groups (DRGs) is a case-mix classification scheme that is used to determine the payment provided to the hospital for inpatient services, regardless of how much the hospital spends to treat a patient. Health care providers, therefore, have an incentive to determine actual costs of services rendered: to keep their costs commensurate with payments for services. It is now common for most hospitals to have sophisticated systems to capture costs by procedure. Some payment methods, such as capitation fees in prepaid health care plans, shift a considerable amount of risk to the provider. That is, the fixed amount of revenue received per patient may not cover the costs of providing the service.
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