U.S. National Library of Medicine

Introduction to Health Services Research : A Self-Study Course

Case Description | Case Background | Case Objectives | Case Exercise

Case 3. Medicare Reimbursement Reforms (Page 11 of 37)

Phase One: Thinking About the Issues

Q2d. How does this regulation, the prospective payment system (DRGs), affect different stakeholders: Private insurance companies?

Suggested Solution

What was the effect on private insurance companies? This group also responded to changes:

• the private insurance companies may end up paying more if hospitals charge them higher fees in order to compensate for Medicare losses
• the companies will likely pass this increase on to the consumers

What other effects can you think of that would affect private insurance companies?

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