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Review
. 1993 Fall;15(1):71-100.

Design of a prospective payment patient classification system for ambulatory care

R F Averill  1 , N I Goldfield, M E Wynn, T E McGuire, R L Mullin, L W Gregg, J A Bender
Affiliations
Review

Design of a prospective payment patient classification system for ambulatory care

R F Averill et al. Health Care Financ Rev. 1993 Fall.

Abstract

The Ambulatory Patient Group (APGs) are a patient classification system that was developed to be used as the basis of a prospective payment system (PPS) for the facility costs of outpatient care. This article will review the key characteristics of a patient classification system for ambulatory care, describe the APG development process, and describe a payment model based on the APGs. We present the results of simulating the use of APGs in a prospective payment system, and conclude with a discussion of the implementation issues associated with an outpatient PPS.

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Figures

Figure 1
Figure 1. Ambulatory Patient Group Class Partitions, by Service Rendered or Procedure Performed
Figure 2
Figure 2. Initial Medical Class Logic
Figure 3
Figure 3. Ambulatory Patient Group (APG) Payment System
See this image and copyright information in PMC

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