The following are results of a monitoring project conducted by the American Medical Association on the impact of the new Prospective Payment System (PPS) for Medicare. Between June and October 1984, the AMA received 334 written responses, many from administrators who wrote on behalf of their staffs. The AMA estimates the responses represented about 6,500 physicians.
Quality of care -- Of the comments received, 37 percent were "positive" in stating that quality had not deteriorated under PPS, while 63 percent stated that quality had deteriorated or that it would deteriorate over time if the PPS continued.
Cost -- 90 percent of physicians responding related instances where reimbursement was inadequate. Ten percent of the comments stated that either the hospital had not lost money on the new system or that the hospital was able to cut costs sufficiently to bring hospital costs in line with the reimbursements.
Admission/discharge policies -- 30 percent stated that hospital policies had changed for the better under PPS; 43 percent reported that hospitals exerted unwarranted pressure to discharge patients early; 27 percent said there had been no change in hospital policies.
Administrative relations -- 28 percent reported an improvement in relations with the administrative staff in implementing PPS; 31 percent reported no change; 41 percent reported a deterioration.