A Prospective Payment System For Hospital Based Physician Services Under Medicare
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Medicare Prospective Payment and the Shaping of U.S. Health Care
Author | : Rick Mayes |
Publisher | : JHU Press |
Total Pages | : 274 |
Release | : 2006-12-20 |
Genre | : Law |
ISBN | : 9780801884542 |
health care system.--Andrew B. Whitford "International Public Management Journal"
Options for Health Insurance
Author | : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health |
Publisher | : |
Total Pages | : 164 |
Release | : 1992 |
Genre | : Business & Economics |
ISBN | : |
Prospective Payment Systems
Author | : Duane C. Abbey |
Publisher | : CRC Press |
Total Pages | : 223 |
Release | : 2018-06-28 |
Genre | : Business & Economics |
ISBN | : 1040084052 |
The third book in the Healthcare Payment Systems series, Prospective Payment Systems examines the various types of prospective payment systems (PPS) used by healthcare providers and third-party payers. Emphasizing the basic elements of PPS, it considers the many variations of payment for hospital inpatient and outpatient services, skilled nursing facilities, home health agencies, long-term hospital care, and rehabilitation facilities along with other providers. The book describes the anatomy of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes. It outlines the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party payers.Provides a framework for understanding and analyzing the characteristics of any PPSDiscusses Medicare prospective payment systems and approachesIncludes specific references to helpful resources, both online and in printFacilitates a clear understanding of the complexities related to PPS covering specific topics at a high level and revisiting similar topics to reinforce understandingComplete with a detailed listing of the acronyms most-commonly used in healthcare coding, billing, and reimbursement, the book includes a series of case studies that illustrate key concepts. It concludes with a discussion of the challenges with PPS including compliance and overpayment issues to provide you with the real-world understanding needed to make sense of any PPS.
Planning a Demonstration of Per-case Reimbursement for Inpatient Physician Services Under Medicare
Author | : Paul B. Ginsburg |
Publisher | : |
Total Pages | : 108 |
Release | : 1986 |
Genre | : Business & Economics |
ISBN | : |
It has been proposed that Medicare pay for inpatient physicians' services on a per-case basis, giving physicians an incentive to economize on services delivered in the hospital. This report outlines the design of a possible demonstration of a system of per-case payment and considers the following key issues in developing such a design: (1) selecting the options most attractive to demonstrate, (2) participation in the demonstration, (3) setting payment rates, (4) site selection, and (5) evaluation of the demonstration. The demonstration would seek to determine how alternative methods of paying physicians would affect costs, beneficiary access and financial liability, and health status outcomes or quality of care.
Medicare Reimbursement for Physician Services
Author | : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health |
Publisher | : |
Total Pages | : 356 |
Release | : 1986 |
Genre | : Diagnosis related groups |
ISBN | : |