Potential "Losers" Under Per-Case Payment
Authors: Earl Steinberg, Gerard F. Anderson
Journal: Annals of Internal Medicine (1987)

Editorials1 June 1987Potential "Losers" Under Per-Case PaymentEARL STEINBERG, M.D., M.P.P., GERARD F. ANDERSON, Ph.D.EARL STEINBERG, M.D., M.P.P.Search for more papers by this author, GERARD F. ANDERSON, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-6-904 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPer-case hospital payment systems (systems in which a predetermined, fixed amount is paid per patient in a particular diagnostic category) are based on the concept of "averaging," the basic assumption being that, although a hospital may lose money on certain patients and earn a profit on others, an efficiently operated hospital will eventually "break even" or earn a small operating surplus in the course of treating many patients. This assumption remains valid as long as the classification system on which payments are based groups patients with similar costs into the same payment category and as long as patients with above-average...References1. SCHWEIKER R. Hospital Prospective Payment for Medicare: Report to Congress. Washington, D.C.: Department of Health and Human Services; 1982. Google Scholar2. HORNBULKLEYSHARKEYCHAMBERSHORNSCHRAMM SGPARC. Interhospital differences in severity of illness: problems for prospective payment based diagnosis-related groups (DRGs). N Engl J Med. 1985;313:20-4. CrossrefMedlineGoogle Scholar3. . Prescription for Change. New York: The Commonwealth Fund; 1985. Google Scholar4. ASHBY J. The Inequity of Medicare Prospective Payments in Large Urban Areas. Washington, D.C.: District of Columbia Hospital Association; 1984. Google Scholar5. . Report and Recommendations to the Secretary, U.S. Department of Health and Human Services. Washington, D.C.: U.S. Government Printing Office; 1985. 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Staging of disease: a case-mix measurement. JAMA. 1984;251:637-44. CrossrefMedlineGoogle Scholar18. BREWSTERKARLINHYDEJACOBSBRADBURYCHAE ABLCRY. MEDISGRPS: a clinically based approach to classifying hospital patients at admission. Inquiry. 1985;22:377-87. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Johns Hopkins Medical Institutions Baltimore, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEncuesta sobre las características y honorarios de la práctica dermatológica privada española en 2018Survey on Private Dermatology Practice Characteristics and Fees in Spain in 2018An alternative safety net to patient dumpingSevere infections in plasmapheresis-treated systemic lupus erythematosusStaffing patterns in hospital clinical dietetics and nutrition support: A survey conducted by the Dietitians in Nutrition Support dietetic practice groupPathogenesis of Multisystem Autoimmunity—SLE as a ModelSilicon Nitride in Epitaxy and SuperlatticesMeasuring performance in clinical rheumatology.Changes in nutrition support services between 1984 and 1986STRAINED MERCY: HOSPITAL STRUCTURE, DRG'S AND PUBLIC POLICYJK coryneforms: a continuing problem for hospital infection control 1 June 1987Volume 106, Issue 6Page: 904-906KeywordsNutrition Issue Published: 1 June 1987 PDF DownloadLoading ...