Medicare pays hospitals on a DRG, Diagnosis Related Group. That means that we are paid a certain amount (less the 2%) based on diagnosis. So even if prices are jacked up, the fee that is paid to the hospital is still going to be the DRG. The patient would be responsible for the portion of the (reasonably priced fee as determined by CMS), not a jacked up price.
Value-based purchasing explained succinctly - thank you!
This video provides an EXCELLENT high level overview of value based purchasing. Very clear and informative. Thank you!
This is the best Value Based Purchasing explanation! Thank you for posting this!! :)
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Excellent should be shown at Hospital QA meetings with new members.
Thanks in a million.
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What if hospitals pass on this 2% cost to all their patients by marking up their prices?
Medicare pays hospitals on a DRG, Diagnosis Related Group. That means that we are paid a certain amount (less the 2%) based on diagnosis. So even if prices are jacked up, the fee that is paid to the hospital is still going to be the DRG. The patient would be responsible for the portion of the (reasonably priced fee as determined by CMS), not a jacked up price.