Pricing Medicare's Diagnosis-Related Groups: Charges versus Estimated Costs

摘要: Hospital payments under Medicare's prospective payment system (PPS) are based on prices established for 474 diagnosis-related groups (DRG's). Previous analyses using 1981 data demonstrated that DRG charges alone were not different from calculated estimated costs. Data 1986 used in this study to show the differences between two sets of much larger than previously reported. If once again costs instead current charge-based prices, would be significantly redistributed.