DRG与美国Medicare Rbrvs之间关系.pptx

DRG’s and RBRVS;Diagnosis-Related Groups for Hospital Payment;Here are some examples of DRGs and weights for the SC Medicaid system. Payment is based on average unit payment for SC hospitals in May 1987, $1263. ;Diagnosis-Related Groups for Hospital Payment;SC Medicaid shortly after DRG’s started;; ; ; ;Incentives in DRG-based payment;Early discharges …;;Quality of Care Before and After Implementation of the DRG-Based Prospective Payment System, A Summary of Effects William H. Rogers, PhD; David Draper, PhD; Katherine L. Kahn, MD; Emmett B. Keeler, PhD; Lisa V. Rubenstein, MD, MSPH; Jacqueline Kosecoff, PhD; Robert H. Brook, MD, ScD JAMA.?1990;264(15):1989-1994. ;Early discharges …;… and readmissions;DRG creep;;;RBRVS;Resource-Based Relative Value System for physician payment;RBRVS = DRGs for doctors?;RBRVS = DRGs for doctors?;Historical context;The UCR Boondoggle: A Death Knell for Private Practice?;RBRVS;Physician work measure for RBRVS;The goal;RBRVS formula;Total Work formula;Compares actual Medicare payments with what Medicare would pay if proportional to RBRV and total-payment-neutral;Potential RBRVS impact;Limitations of RBRVS;As implemented by SC Medicaid