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It describes rapid environmental shifts driven by provider excess and rising healthcare costs, then explains how DRGs change reimbursement from input to unit output. The article argues that physicians lose control of patient access as risk shifts from payer to provider, requiring new hospital-physician relationships. It also critiques prior utilization review incentives and outlines challenges from countervailing fee structures.",{"@graph":69,"@context":113},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-hospital-medical-staff-volume-13-number-2-february-1984/570606/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-hospital-medical-staff-volume-13-number-2-february-1984/570606.png","ImageObject",300,407,{"name":92,"@type":93},"Finn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-13",true,{"@type":101,"interactionType":102,"userInteractionCount":4},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107],{"name":108,"@type":109,"acceptedAnswer":110},"Why are hospitals required to change relationships with medical staffs under DRGs?","Question",{"text":111,"@type":112},"Risk for healthcare costs shifts from the payer to the provider, creating a mandatory change in how hospitals and physicians coordinate incentives and decisions.","Answer","https://schema.org",{"og:url":83,"og:type":115,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":117,"canonical":83},"index,follow",{"doc_id":119,"site_id":62},570606,1791882093,{"code":4,"msg":5,"data":122},{"doc_id":119,"user_id":123,"nickname":92,"user_avatar":124,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":125,"file_id":126,"file_url":127,"file_type":128,"file_size":129,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":130,"language":131,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":67,"update_tm":120,"read_time":135},34359740700684,"https://ap-avatar.wpscdn.com/avatar/1f400023980c374ae676?_k=1777273430885731487","The medical staff roleunderprospectivepricing  \nEnhancing managerialskills through theleader-match concept  \nEditorial Advisory Board  \nCatherine De Angelis,M.DJohns Hopkins HospitalsBaltimore  \nStuart Ashman,M.D.Tidewater Psychiatric InstituteVirginia Beach,VA  \nDon E.Detmer,M.D.University of WisconsinMadison,WI  \nStuart L.Fischman,D.M.D.Erie County Medical CenterBuffalo,NY  \nSpencer Foreman,M.D.Sinai Hospital of Baltimore  \nRobert B.Hunter,M.D.Sedro Wooley,WA  \nSteven Landgarten,M.D.Hillcrest Medical CenterTulsa,OK  \nDurward M.Lang,M.D.VA HospitalSioux Falls,SD  \nMary H.Morris,R.NHenry Ford HospitalDetroit  \nDennis S.OLeary,M.D.  \nGeorge Washington University HospitalWashington,D.C.  \nVirginia L.Piper  \nAbbott Northwestern HospitalMinneapolis,MN  \nSamuel D.Porter,M.D.  \nMason CityIA  \nJoseph H.Powell  \nBaptist Memorial Hospital  \nMemphis  \nJames H.Stuart,M.D.  \nYork (MEJ Hospital  \nRobert C.Winslow,M.D.  \nMiami Valley Hospital  \nDaytonOH  \nEditor and Publisher:DanielS.SchechterAssociate Publisher:Rex N.OlsenExecutive Editor:Wesley CurryManaging Editor:Carol KeenanStaff Assistant:Richard WilkinsonProduction and Art:Kathleen O'LearySusan SchuylerCirculation:Mary E.McKillipRose CooperEarnestine Farley  \nOpinions expressed by authors puh-lished in The Hospital Medical Stajf donot necessarily reflect positions of thepublisher or of the American HospitalAssociation.  \nVolume 13 Number 2·February 1984  \n#     THE     HOSPITALMEDICAL    STAFF\n\nPublished monthly  \nby American Hospital Publishing,Inc.for the American Hospital Association,John Alexander McMahon,president  \n3 The Medical Staff Role underProspective PricingSteven Landgarten,M.D.  \n6 Clinical and Financial  \nManagement Must Merge underProspective Pricing  \n11 WASHINGTON MEMO  \n14 Enhancing Managerial Skillsthrough the Leader-Match ConceptKevin Hynes,Ph.D.,andNathaniel Givner,Ph.D.  \n20 The Medical Care Committee:Clearinghouse for Medical StaffQuality Assurance ActivitiesJoseph L.Murphy,M.D.,andTerry L.Ostrowski,M.D.  \n25 BRIEFLY NOTED  \n28 CALENDAR  \n# The medicalstaff role\n\nunder prospective pricing        \nby Steven Landgarten,M.D.  \nON OCTOBER 1,1983,American medicineentered the era of diagnosis-relatedgroups(DRGs).Yet,this is only thebeginning.Other prospective pricingprograms sponsored by employers,in-termediariesand even providers willsoon be knocking on the door.Thus,ifhospitals are to survive,they mustlearn to prosper in a new environment.This adaptation will require changes inbehavior not only on the part of healthcare institutions,but also in therelationship between hospitals andmedical staffs.For the first time,adap-tation also will require changes in theclinical behavior of physicians.  \nViewing DRGs as a code word forthe entire spectrum of prospective pay-  \nSummary-Physicians and hos-pitals who survive under DRGswill be those who learn tomodifytheir behavior to work within therealities of the new health careenvironment.  \nment,and case-mix systems,here is ananalysis and strategy for the hospitaland its medical staff.  \nThe most important characteristicof the health care environment,ontowhich DRGs are being grafted,is therapidly changing competitive environ-ment.Several factors have contributedto this rapid change.The first is pro-vider excess,an excess evident on thephysician side certainly,but also on thehospital side.  \nAnother critical factor in the evolu-tion ofthe present health care system isrising costs.This has been detailed else-  3  \nwhere.Suffice it to say that the healthcare industry responded appropriatelyto the stimuli in the environment asgovernmental action was inevitable.  \nThe impact of rising health carecosts has also been felt in the corporatecommunity,and many of the“alterna-tive\"payment schemes are a responseto this corporate concern.The prolif-eration of HMOs,PPOs,and others is  \nIndividual physicians are losingcontrol of the access ofindividual patients to thehealth care system  \ntestament to the willingness of the cor-porate communit","cbCaii3bPGh046ij","https://ap.wps.com/l/cbCaii3bPGh046ij","pdf",4219746,35,"English","# The Medical Staff Role under Prospective Pricing\n## Clinical and Financial Management Must Merge under Prospective Pricing\n## Washington Memo\n## Enhancing Managerial Skills through the Leader-Match Concept\n## The Medical Care Committee: Clearinghouse for Medical Staff Quality Assurance Activities\n## Briefly Noted\n## Calendar","[{\"question\":\"Why are hospitals required to change relationships with medical staffs under DRGs?\",\"answer\":\"Risk for healthcare costs shifts from the payer to the provider, creating a mandatory change in how hospitals and physicians coordinate incentives and decisions.\"}]","THE HOSPITAL MEDICAL STAFF - Volume 13 Number 2 - February 1984 | PDF",88]