In this article the authors explore the potential role of DBC-costing (from this point on used as a synonym for DRG-costing) for supporting hospital’s strategic choice, as they will argue that two arguments feed their preliminary expectation that DBC-types of costing may support hospital’s strategic management. First, the basic logic of DBC-type costing systems shows similarities with cost management techniques that have been proposed in theory and practice under the heading of strategic costing (Cooper & Slagmulder, 2003, 2004; Baxendale & Raju, 2004). DBCcosting specifically seems to build on the ideas of activities as cost drivers, as is central to ABC-analyses. The authors will elaborate on these similarities more extensively below. Second, DBCs provides hospitals with a major and costly change, which by itself calls for any analysis of its associated costs and benefits of the related strategic moves.