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New Jersey has had many calls from outside the State from agencies and individuals concerned about DRGs and Medicare.
The level of knowledge ranged from some familiarity to total ignorance of even simple data requirements.
The second issue is the importance of monitoring quality of
Quality of care is very difficult to measure.
be measured by a criterion such as outcome
In New Jersey, we believe that peer review is an important component in monitoring quality of care, and the PSROs serve this
The value of an independent organization to monitor
the utilization of hospital care cannot be refuted.
Third, there should be a mechanism for addressing new technology.
In New Jersey, the Rate Setting Commission hears testimony from a
hospital (or hospitals), the Department of Health, and the
Commissioner's Physician Advisory Committee.
If evidence is
available that a new technological advance is worthwhile, then
the hospital is awarded additional reimbursement.
The hospital can also obtain additional reimbursement for
new technology through the appeals process for those approved
certificate of need projects.
It is important to note that while the problems of rising
hospital costs may be similar nationally, a prospective payment system may not have identical results in Idaho as in Pennsylvania.
In those instances where a state can implement their own system, designed to meet the federal objective, then flexibility or waivers
for state initiatives should be allowed.
In conclusion, we in New Jersey have been working with DRGS since 1976. We feel very strongly that DRGs have a great benefit
in terms of allowing hospitals to use available resources wisely and to help contain health care costs for payers and consumers.
Now that all New Jersey acute care general hospitals are
finally billing by DRGs, we should be in a position to see exactly
how much of an impact DRGs can have on a state's health care
expenditures and clinical management.
Report to Congress Hospital Prospective Payment
Richard S. Schweiker
0.S. COROCNTTT HOSPITALS
man INCULASZ POLISZ PLI ADJUSTID ADMISSION
15 16 17 10
26 27 28 29 30
Those programs wich require hospitals born to participate and comply.