Nurse Executive Certification Exam Prep

Category - Nurse Executive Practice Test

Diagnosis-Related Groups (DRGs) determine what kind of reimbursement?
  1. Medicare prospective reimbursement
  2. Medicare retrospective reimbursement
  3. Medicaid prospective reimbursement
  4. Medicaid retrospective reimbursement
Explanation
Answer: A - Diagnosis-Related Groups (DRGs) determine the amount of reimbursement that Medicare will provide. It is a prospective reimbursement method that is based on the patient’s medical diagnosis, necessary procedures, and their needs, rather than on the length of stay or the actual cost of services provided. It is, therefore, a prospective, rather than a retrospective, type of reimbursement.
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