Over the past three decades there has been a substantial decline of autopsy rates within community hospitals and academic medical centers. In the years after World War II the autopsy rate approached 50 percent. The current rate is 10 to 15 percent. In teaching hospitals the rates are generally higher (75 percent in 1960, 71 percent in 1970, 38 percent in 1980) than in community hospitals; however, the decline is dramatic for these hospitals as well. In view of this marked downward trend, coupled with uncertainties surrounding the restructuring of the payment system of medical care, we undertook this study to: (1) assess the current benefits derived from the autopsy; (2) identify those factors responsible for the decline; (3) analyze and project the potential impact of prospective reimbursement on the finance mechanisms for the autopsy; and (4) identify those steps most likely to reverse the current trend. As part of this study we conducted a survey of autopsy rates and reimbursement mechanisms within the hospitals in the Washington, D.C. metropolitan area. The word “autopsy” comes from Greek, meaning “a seeing for oneself.” The autopsy is a post-mortem medical examination for studying the pathologic changes present and determining the cause of death. The autopsy includes three kinds of examinations: an inspection of the external body; an examination and dissection of the internal organs and vital structures; and a microscopic examination of selected tissues. The extent of the autopsy varies according to the purpose for which it is performed. It may be limited to an external examination (as is done for some forensic cases); it may involve a limited dissection of specified organs; or it can consist of an extensive gross and microscopic evaluation. Incisions are limited to portions of the body which are not displayed during funeral