A client's spouse is concerned about the cost of hospitalization. The nurse says, "Because your spouse is on Medicare, the hospital will be paid according to the DRG." What does the nurse mean by this statement?

Question

Quizplus · Accepted Answer

1. Total cost is the amount of the charges for which the client is billed. Medicare reimbursement does not equal this amount.
2. An average for the costs is not a payer amount used by the healthcare industry.
3. Medicare does not pay based upon the usual cost of the procedure.
4. Medicare payment for inpatient services is currently made at a predetermined specific rate for each Medicare recipient based on the patient's diagnosis. Care is classified into diagnosis-related groups (DRGs).

A Client's Spouse Is Concerned About the Cost of Hospitalization