An older adult client was admitted to the hospital with the condition classified as "pneumonia." Reimbursement was based on a predetermined fixed price. This classification system is referred to as:
a. diagnosis-related groups (DRGs).
b. subjective symptom management.
c. acuity classification system.
d. organized managed care.
ANS: A
Correct: DRGs are used in reimbursement for health care services based on a predetermined fixed price per case or diagnosis in 468 categories. Under DRGs, each Medicare client is assigned to a diagnostic grouping on the basis of his or her primary diagnosis at hospital admission. Medicare limits total payment to the hospital to the amount preestablished for that DRG.
Incorrect:
b. Subjective symptom management is not a reimbursement type that is based on predetermined pricing.
c. Acuity classification system is not a reimbursement type that is based on predetermined pricing.
d. Organized managed care is not a reimbursement type that is based on predetermined pricing.
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