Certified Medical Assistant Practice Exam

A method of containing hospital costs has been adopted with a system called

1. EDI system

2. Healthcare saving plan

3. ICD coding solution

4. DRGs

The correct answer is: DRGs

The correct answer, DRGs, stands for Diagnosis-Related Groups. This system was developed to help hospitals manage costs and control spending by categorizing hospital cases into groups that are expected to have similar hospital resource uses. Under this system, hospitals are reimbursed a fixed amount based on the patient’s diagnosis, rather than the specific services provided. This creates an incentive for hospitals to use resources more efficiently, as they would keep any savings generated from reduced costs while maintaining quality of care. The implementation of DRGs has had a significant impact on hospital budgeting and operational practices by encouraging hospitals to reduce unnecessary procedures and length of stay, ultimately optimizing healthcare delivery. In contrast, while an EDI system is related to the electronic exchange of data in transactions, it does not specifically address or contain hospital costs directly. A healthcare savings plan typically involves patient-driven funding options for their healthcare costs but does not encompass the systematic cost control mechanisms applied within hospitals. ICD coding solutions are involved in classifying diseases and related health conditions for billing and record-keeping purposes but do not play the same systematic role in controlling hospital costs as DRGs do.