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Title
Should insurers pay the same fees under an all-payer system?
First Author
Kominski, Gerald F
Date of Pub
1994 Winter
Pages
175-189
Volume
16
Issue
2
Other Authors
Rice, Thomas
Abstract
Medicare's use of diagnosis-related groups (DRGs) and the resource-based relative value scale (RBRVS) has led to interest in developing a national all-payer system in which insurers use the same payment methods and payment rates. Using data for 81 high-volume DRGs from 457 California hospitals, we conclude that a single set of rates for hospital care would not be appropriate. On average, Medicare patients were 11.7 percent more expensive than commercially insured patients, but less expensive in many DRGs. Further research is needed to determine if Medicare patients require more physician resources compared with non-Medicare patients, particularly for surgical procedures.
Abstract Continued
N/A
MeSH
Prospective Payment System : Relative Value Scales : California : Health Services Accessibility : Health Services Research/methods : Insurance, Hospitalization/statistics & numerical data/standards : Insurance, Physician Services/statistics & numerical data/standards : Organizational Objectives : Private Sector : Public Sector : Rate Setting and Review/standards : Regression Analysis : Support, U.S. Gov't, P.H.S.
NTIS Number
PB99-106486