Page images
PDF
EPUB

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.

B. MONITORING

The second issue is the importance of monitoring quality of care. Quality of care is very difficult to measure. Can quality be measured by a criterion such as outcome

alive/dead?

In New Jersey, we believe that peer review is an important

:

component in monitoring quality of care, and the PSROS serve this function. The value of an independent organization to monitor

the utilization of hospital care cannot be refuted.

C. NEW TECHNOLOGY

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.

D. STATE FLEXIBILITY

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.

SUMMARY

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.

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

Those programs which require hospitals both to participate and comply.

[blocks in formation]
[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small]
« PreviousContinue »