Having used DRGs extensively over the past decade for research, trend analysis and funding purposes, it is apparent to me that we have come a long way since the early inception of the DRG work by Fetter and the Commonwealth need to be acknowledged for the leadership and support they have provided in this process. However it is also apparent that we can make more significant improvements given what we have learned to date. I am interested in structural changes of DRGs for at least three purposes: funding, clinical understanding, and strategic development of service delivery.