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US prepares for imminent Centers for Medicare & Medicaid Services outpatient, ambulatory reimbursement

This article was originally published in Clinica

Executive Summary

When US Medicare proposed sweeping changes in how it calculates diagnosis-related groups (DRGs) under its inpatient payment system earlier this year, it prompted a policy uproar. Analysts weighed in with estimates of earnings losses, while the device industry formed coalitions, commissioned studies, held high-profile press conferences and advertised in key newspapers. Ultimately, the strategy worked. The health plan's proposed payment strategies for both outpatient and ambulatory surgical centres have been treated with far less fanfare.

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