In today’s hospital system selling environment, access alone isn’t enough; relevance is everything. To earn the time and trust of hospital decision-makers, account managers must demonstrate a deep understanding of how hospitals operate financially. One of the most critical, but often overlooked, factors? Diagnosis-Related Groups (DRGs).
DRGs are the systems at the heart of how hospitals get paid. Under this system, Medicare and many commercial payers reimburse hospitals a fixed amount based on the patient’s diagnosis, procedures, and comorbidities—not on the actual cost of care. That means hospitals are incentivized to manage resources efficiently within that fixed payment.¹
So why should account managers care?
Because products, therapies, and services that help hospitals deliver faster, safer, more cost-effective care, without exceeding the DRG payment, become far more compelling. Whether it's reducing length of stay, minimizing complications, or supporting appropriate coding and documentation, account managers who can connect the dots between clinical value and financial impact are better positioned to influence buying decisions.¹˒²
Training your teams to understand DRG mechanics empowers them to¹⁻³:
Align messaging with hospital cost-containment goals
Position solutions as part of a value-based care strategy
Identify stakeholders beyond physicians
It’s not just about product benefits anymore; it’s about hospital performance, reimbursement, and sustainability.¹˒³
Fuel for thought
At OCTANE, we train account teams to understand how operational systems, like DRGs, shape hospital decision-making. Account managers must be prepared to speak to more than clinical outcomes—they need to show how their product fits within bundled payment models and supports hospital efficiency, safety, and reimbursement goals. When account managers understand how DRGs drive value, they can position their product as a solution aligned with both patient care and financial performance.
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References
Centers for Medicare & Medicaid Services. Design and development of the diagnosis related group (DRG). Updated 2024. Accessed July 2025.
Chen Y, Zhang X, Yan J, Tang X, Qian M, Ying X. Impact of diagnosis-related groups on inpatient quality of health care: A systematic review and meta-analysis. Inquiry. 2023.
Ren S, Yang L, Du J, He M, Shen B. DRGKB: a knowledgebase of worldwide diagnosis-related groups’ practices for comparison, evaluation and knowledge-guided application. Database. 2024.
