Table 7. What is Included in DRG Payment?
| Cost Type | BCBSA Products | Medicaid Plans | ||||||
|---|---|---|---|---|---|---|---|---|
|
|
|
|||||||
| Total | Included | Separate Payment | Not Paid | Total | Included | Separate Payment | Not Paid | |
| Number | ||||||||
| Capital | 95 | 85 | 4 | 6 | 21 | 9 | 12 | 0 |
| Direct Teaching | 91 | 76 | 6 | 9 | 21 | 10 | 11 | 0 |
| Indirect Teaching | 92 | 81 | 1 | 10 | 21 | 15 | 5 | 1 |
| Disproportionate Share | 93 | 68 | 0 | 25 | 21 | 7 | 14 | 0 |
| Uncompensated Care | 92 | 71 | 2 | 19 | 21 | 1 | 5 | 15 |
| Percent | ||||||||
| Capital | 100 | 89 | 4 | 7 | 100 | 43 | 57 | 0 |
| Direct Teaching | 100 | 83 | 7 | 10 | 100 | 48 | 52 | 0 |
| Indirect Teaching | 100 | 88 | 1 | 11 | 100 | 71 | 24 | 5 |
| Disproportionate Share | 100 | 73 | 0 | 27 | 100 | 33 | 67 | 0 |
| Uncompensated Care | 100 | 77 | 2 | 21 | 100 | 5 | 24 | 71 |
NOTE: Data missing for 5 to 9 BCBSA products, depending on item. DRG is diagnosis-related group. BCBSA is Blue Cross and Blue Shield Association.
SOURCE: Carter, G.M., Jacobson, P.D., Kominski, G.F., and Perry, M.J., RAND, 1994.