Managing DRGs: knowing what to cut--and when.
Medicare's new DRG prospective reimbursement is based upon a methodology diametrically opposed to the incentives of its traditional retrospective, cost-based system. The agreement to a phase-in period for DRGs, with reimbursements based on both the cost-based and DRG-based methodologies for three years, creates a fundamental conflict and unique managerial challenge for radiology and other hospital administrators. It means they must know both what to cut under DRGs and when to cut them during and after the phase-in.
D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D006748:Hospital Departments / Q000458:organization & administration*; D008331:Management Information Systems; D011445:Prospective Payment System / Q000331:legislation & jurisprudence; D011872:Radiology Department, Hospital / Q000458:organization & administration*; D014481:United States