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Hospital reimbursement under Medicare.

Judith R. Lave

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Abstract

Although hospital care forms the largest expenditure under Medicare, long-term reforms in the basic reimbursement system should be approached cautiously. The effects of newly mandated changes--prospective payment and DRGs--have yet to be evaluated, but some modifications should be considered for the near term. Uniform, national payment rates and adjustments for teaching are especially critical areas.

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What this paper is about

Although hospital care forms the largest expenditure under Medicare, long-term reforms in the basic reimbursement system should be approached cautiously. The effects of newly mandated changes--prospective payment and DRGs--have yet to be evaluated, but some modifications should be considered for the near term. Uniform, national payment rates and adjustments for teaching are especially critical areas.

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Available abstract

Although hospital care forms the largest expenditure under Medicare, long-term reforms in the basic reimbursement system should be approached cautiously. The effects of newly mandated changes--prospective payment and DRGs--have yet to be evaluated, but some modifications should be considered for the near term. Uniform, national payment rates and adjustments for teaching are especially critical areas.

Key concepts: Reimbursement, Prospective payment system, Payment, Actuarial science, Term (time), Business, Hospital care, Medicine

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