Originally APG (Ambulatory Payment Groups) were developed in response to the Omnibus Budget Reconcilliation Act of 1986 which directed the Health Care Financing Administration (HCFA) to develop a prospective payment system for the facility component of ambulatory care rendered in hospital ambulatory surgery, emergency room and outpatient clinic settings. Later, the name evolved to APC's (Ambulatory Payment Categories) APCs are similar to both DRGs (Diagnosis Related Groups) used for hospital inpatient reimbursement and RBRVS (Resource Based Relative Value System) used for physician reimbursement. Beginning in 1991 with Blue Shield of California, a number of third party payers have adopted some form of APC based reimbursement. Washington, Iowa, Maryland, and Massachusetts payers have mandated APCs. We expect that the ACG system will become the standard for virtually all payers, including Medicaid within the next few years.

  Effective management systems for Ambulatory Patient Categories will be important for successfully providing outpatient services. Health Systems Management network can help implement and integrate APCs into :

• Operations
• Clinical Documentation
• Documentation Systems
• Patient Accounts/ Financial Management