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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Introduction to Health Services Research : A Self-Study Course

Case Description | Case Background | Case Objectives | Case Exercise

Case 3. Medicare Reimbursement Reforms (Page 6 of 37)
Phase One: Thinking About the Issues

Q1b. What are the effects of the Medicare prospective payment reimbursement system on the quality of health care for the elderly? In other words, what are the issues in this scenario?

Suggested Solution

You might wish to investigate the following questions.

  • How does the reduced length of stay in care facilities affect overall health status?
  • Is there an incentive for hospitals to let people go before they are completely well?
  • Does the hospital make a profit?
  • How can we tell if the quality of care remains high in a PPS environment?
  • How has management responded to fixed amounts for a DRG? Has this affected quality?
  • Is the patient still ill when he/she leaves the hospital?
  • Has the patient been released too soon?
  • How does this regulation, the prospective payment system (DRGs), affect different stakeholders?
  • What is the effect of early release on the families of the sick person?

What other questions can you think of?

Next question...

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