The nurse is caring for a patient who is on Medicare.Because the patient is on Medicare,the nurse is aware that

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In 1983,Congress established the prospective payment system (PPS),which grouped inpatient hospital services for Medicare patients into 468 diagnosis-related groups (DRGs),each of which provides a fixed reimbursement amount based on assigned DRG,regardless of a patient's length of stay or use of services.This encourages hospitals to provide more efficient services because costly stays may not be fully covered.Capitation means that providers receive a fixed amount per patient or enrollee of a health care plan.DRG reimbursement is based on case severity,rural/urban/regional costs,and teaching costs,not national averages.

The Nurse Is Caring for a Patient Who Is on Medicare.Because