The Effects of DRG Pricing on Hospital Length-of-stay of Patient

By 1982, the regulatory building for government health insurance for the elderly (Medicare) was based on a new hospital reimbursement methodology and utilization authorization mechanism in the form of the Peer Review institution (PRO) program. Soon thereafter (in 1983), the Diagnosis Related Groups (DRG) program of character and cost criticism was implemented. Before then, reimbursement had been paid on fee-for-service foundation (Skinner, 1997). Enforcement procedures included denial of payment for unnecessary care, an intensified review for those providers not meeting a threshold of compliance, and exclusion from Medicare and fiscal penalties for failure to meet professionally recognized standards of care calibre (Gosfield, 1994).

DRG procedures, with respect to provider reimbursement, were introduced by the federal government on with a general prospective payment system (PPS), and a system for the selection of providers to deliver health care serve funded by the federal government, which is known as the preferred provider organization (PPO) system. DRG is a procedure used in the miscellany of patient groups. DRG classifications are used in PPS reimbursement determinations. These procedures (DRG) are too used in decision-making related to (1) service access, and (2) in th

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