Under DRG-based reimbursement, what primarily determines the payment amount for a patient admission?

• A. Length of stay alone.
• B. Diagnosis-related group weight and base rate.
• C. Number of procedures performed.
• D. Patient's age.

Answer: (B)

Under DRG-based reimbursement, the payment for an admission is driven by the assigned diagnosis-related group weight multiplied by a base rate. The DRG weight represents the expected resource use for that group, and the base rate sets the standard per-discharge amount (with possible geographic or other adjustments). This means the fixed DRG payment reflects the typical cost of the case, rather than being based on length of stay, the exact number of procedures, or the patient’s age. Outlier adjustments may apply for unusually costly cases, but the core payment is determined by the DRG weight and the base rate.