Do unprofitable patients face access problems?

Tests were conducted to determine whether implementation of the prospective payment system caused access problems for patients with an above-average likelihood of being unprofitable. Since implementation, patients in diagnosis-related groups that are, on average, unprofitable are not more likely to be transferred. However, they are more likely to be found in hospitals of last resort (the only evidence from these tests indicating access problems). Outlier patients are not more likely to be found in last-resort hospitals. The access issue will continue to bear scrutiny, but there is not as yet evidence that it is a serious problem.