In the Jefferson case, the District Court considered actual and prospective payments by the Veterans' Administration as diminution of the verdict.
Strangely, for a change that is supposed to promote efficiency, chains that formerly had high costs, like Beverly Enterprises, the biggest nursing home chain, will be rewarded, as the nursing home day rates, called prospective payments, are phased in over four years.
For example, Medicare promoted the adaptation of prospective payments based on DRG's, which prevents unscrupulous providers from setting their own exorbitant prices.
Secondly, the current pattern of provision grew up initially on the basis of 'full cost reimbursement' and latterly on 'prospective payment', in both cases from non-cash-limited public funds.
DRG 'Diagnosis Related Group,' the term Uncle Sam uses to describe prospective payment to a hospital, could mean 'Damned Regulatory Government' to the medical profession or 'De [The] Revenues Gone' to the hospital administration.
From 1983 to 1986, Medicare physician fees were frozen, and prospective payment to hospitals based on diagnostic groups was introduced.
According to the analysis, the changes are designed to further the objectives of the prospective payment system,2 while maintaining the financial viability of the hospital industry and ensuring access to high quality health care for Medicare beneficiaries.
Virginia and most other states adopted plans that provided prospective payments, rather than actual reimbursement, based on what various procedures and treatments should cost.