Suchergebnisse

THE UNRESTRAINED RISE IN HOSPITAL COSTS, WITH EXPANDED FEDERAL FINANCING, HAS LED TO THE ESTABLISHMENT OF THREE TYPES OF GOVERNEMENT CONTROL PROGRAMS AIMED AT CURBING THE RISE OF HOSPITAL COSTS. THE FIRST TWO HAVE BEEN LARGELY INEFFECTIVE. THE THIRD, CONTROL OF REIMBURSEMENT THROUGH PROSPECTIVE PAYMENT SYSTEMS, SEEMS PROMISING. HOSPITAL COST BASED ON DIAGNOSIS RELATED GROUP HAS BEEN TRIED.

Use of prospective reimbursement -- ie, setting payment rates in advance -- as a means of government control over rising hospital costs is discussed. The growing governmental role in hospital payments since the enactment of Medicare & Medicaid is examined, noting the unequal distribution of repayment in the current retroactive reimbursement formats & the long-range incentives for hospitals to increase volume regardless of costs. The pilot prospective programs initiated by Blue Cross & some state systems are evaluated; while persistent fractionalization problems are identified, cost inflation is seen as slowing in NJ & Md health units having prospective plans. Potential development of the Diagnosis Related Groups system used in NJ is also considered. 1 Table. L. Whittemore.