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Hospital prospective payments: a strategy for change.

The United States Congress is now considering a new system of prospective payments to hospitals for services provided under the Medicare and Medicaid programs. It is a system which would provide an immediate restraint on the growth of federal expenditures for these programs and one which would allow hospitals to move immediately to more stringent cost control measures. Moreover, it is a system which would have repercussions upon physician services in hospitals and upon hospital staffs.