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Health Care Systems/Health Policy Exam 2025 Questions and Answers 1. An older adult client was admitted to the hospital with the condition classified as "pneumonia." Reimbursement for care was based on a predetermined fixed price. What is this classification system referred to as? a. Diagnosis-related groups (DRGs) b. Subjective symptom management c. Acuity classification system d. Organized managed care - ....ANSWER ...-ANS: A DRGs are used in reimbursement for health care services based on a predetermined fixed price per case or diagnosis in 468 categories. Under DRGs, each Medicare client is assigned to a diagnostic grouping based on his or her primary diagnosis at hospital admission. Medicare limits total payment to the hospital to the amount preestablished for that DRG 2. The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, known as a _____ nurse. a. case management b. quality assurance c. utilization review …FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1