What is the purpose of additional payments for outlier cases in hospitals?

The purpose of additional payments for outlier cases in hospitals is to support hospitals financially during costly treatments. Outlier payments are specifically designed to address the financial burden that certain cases may impose on healthcare facilities.

When a patient’s treatment costs significantly exceed the typical amount for a given diagnosis-related group (DRG), the hospital may find it challenging to cover the associated expenses under standard reimbursement rates. Outlier payments ensure that hospitals receive additional compensation for these exceptionally high-cost cases, thus mitigating potential losses and allowing them to continue providing care without financial detriment. This approach helps maintain the overall viability of healthcare facilities and reinforces the quality of patient care by ensuring that hospitals are adequately funded to handle complex and resource-intensive cases.

In contrast, other options focus on aspects like patient turnover and outpatient procedures, which are not the primary reason for outlier payments. These payments are specifically geared towards addressing significant cost disparities rather than reducing expenses or altering care delivery models.