“…Despite a strengthening of the center, preliminary assessments of NPM reforms underscore difficulties in using DRGs (Moisdon, ) to guide policy‐making (Or, ) and to compensate care providers adequately (the same DRG scale is used for both public and private providers even though they fulfill different missions). Moreover, economic evaluations suffer from assumptions used in economic modeling and conflicts of interest (Merlo, Page, Ratcliffe, Halton, & Graves, ; Thiebaut, Champagne, & Contandriopoulos, ). Daunting challenges such as hypercomplexity (Klein & Young, ; management tools such as DRGs did not simplify the public management exercise) and gaming (i.e., the up‐coding of a disease into an upper DRG category benefiting from a higher compensation rate) remain (Gao, ; Lowe & Wilson, ).…”