DRGs are used to categorise hospital admissions into groups that are expected to have similar levels of resource utilisation. Insight’s DRG is the most widely used solution in South Africa. Applications of the DRG model include in hospital analytics, benchmarking and contracting. DRGs allow the analysis of in hospital medical scheme expenditure on a case mix adjusted basis, which takes into account the different types of admissions seen in different hospitals. This means engagements with hospitals on reimbursement models, and cost and quality improvement initiatives are more progressive and fruitful.