Achieving cost control in the hospital outpatient department.
The rapid growth in outpatient expenditures and the congressional mandate for development of a prospective payment system (PPS) for these expenditures are discussed. Extension of diagnosis-related groups to outpatient care is shown to be infeasible. Alternative patient classification schemes and options for defining the unit of payment and establishing weights and rates are discussed. A PPS primarily controls price and can only address volume by defining a broad unit of payment, such as an episode of care. Therefore, adoption of a volume performance standard approach could be effective. Outpatient payment policies must be integrated with those of other ambulatory care providers.
Sulvetta
M B
MB
Urban Institute, Washington, DC 20037.
D000553:Ambulatory Care / Q000145:classification* / Q000191:economics; D000555:Ambulatory Care Information Systems; D000556:Ambulatory Surgical Procedures / Q000191:economics; D003363:Cost Control / Q000379:methods*; D003953:Diagnosis-Related Groups; D005102:Health Expenditures / Q000639:trends; D006278:Medicare / Q000706:statistics & numerical data / Q000639:trends*; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D011445:Prospective Payment System / Q000639:trends*; D013659:Tax Equity and Fiscal Responsibility Act; D014481:United States