Prospective reimbursement based on diagnostic related groups (DRGs) has been selected by Medicare as a potential solution to escalating health care costs. Will the prospective reimbursement system really lower costs? Will it lower quality too? What can critical care nurses do to increase quality while decreasing costs? In this article, the first in this set on DRGs, the author analyzes the actual practice of the DRG prospective reimbursement system so the critical care nurse can project how this new financial system will affect critical care.