In a little-known quirk, 11 cancer centers in the United States are exempt from the prospective payment system (PPS) that Medicare uses to pay hospitals for inpatient and outpatient care. The US Government Accountability Office found that these PPS-exempt cancer hospitals receive annual payments that in aggregate are hundreds of millions of dollars in excess of those to local teaching hospitals for treating inpatients and outpatients with the same level of disease complexity.1 This exception dates from 1983, when Congress established the inpatient PPS with the diagnosis-related group (DRG) methodology, and continues 36 years later.
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Steinbrook R. Paying for Cancer Care. JAMA Intern Med. Published online June 17, 2019179(8):1051. doi:10.1001/jamainternmed.2019.0892
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