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Understanding the financial implications of APGs (ambulatory patients groups)
1Abbey & Abbey, Consultants, Inc., Ames, IA, USA.
Abstract:
The ambulatory patient group (APG) system, a new prospective payment system for reimbursing outpatient services, is being adopted by increasing numbers of third-party payers and may soon be used in the Federal Medicare program. APGs involve the grouping of healthcare services provided during a specified service period. Payment rates are complicated by the assigning of multiple APGs to a single patients encounter and by discounting schedules. APG cost management tools must be developed to assess the financial impact of this complex system.
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