Comment by hermanzegerman

Medicare reimburses by DRG, which is a payment for the average cost patients with that diagnosis and comorbidities have.

Usually those hospitals send the patients they expect to become to cost more than the DRG Reimbursement (Complications, too old, too many comorbidities) off to public hospitals. At least that's how it works in Germany. At the same time, they are very aggressive with upcoding their diagnoses to get more reimbursement.