Two clients are having joint replacement surgery on different joints. The nurse manager of the unit knows that there is a predetermined payment for this procedure because of what?
A) Social Security
B) Medicare and Medicaid
C) Diagnosis-related groups
D) Private pay insurance

Question

Quizplus · Accepted Answer

Diagnosis-related groups (DRGs) are a payment system used by Medicare and Medicaid to reimburse hospitals for inpatient care. DRGs group patients with similar clinical characteristics and determine a predetermined payment amount for a specific diagnosis or procedure, such as joint replacement surgery. This payment system is meant to incentivize hospitals to provide efficient and cost-effective care, while also ensuring that patients receive appropriate services.

Two Clients Are Having Joint Replacement Surgery on Different Joints