By NextBestFitMedicare hospital payment systems (IPPS DRGs, OPPS)
replacedYears 1–4 (converging)Provider payment & regulation
Today
Per-case and per-service rates for Medicare; commercial insurers pay negotiated prices about 2.5x Medicare.
Under the plan
Replaced by global operating budgets at about 120% of Medicare-equivalent volume; DRGs retained as a measurement tool and for out-of-region patients.
Trade-off
Spending control and less billing vs. weaker volume incentives.