Practices and inspirations of the DRGs payment rate calculation for seniors medical insurance in the United States / 中华医院管理杂志

ABSTRACT

In terms of the definition of normal cases and abnormal ones, the paper systematically analyzed the DRGs payment for American seniors Medicare, focusing on the mechanism of the basic payment rate and additional payment rate for normal and abnormal cases. These experiences prompt to maintain the stability of the payment modes transition, motivate medical institutions, and pay attention to differences among such institutions for fine management of medical insurance.