Problem
There are 5 different facility types listed below with three questions to answer for each facility. Use the MLN Educational Tool for Medicare Payment Systems & Prospective Payment Systems and Rules for Reimbursement to assist you with this question. Please pay attention to the abbreviations and the specific name for each abbreviation, and the difference between each cost-based and price-based payment system.
A. Summarize the difference between:
B. Summarize the difference between a cost-based reimbursement system and a price-based reimbursement system.
a. Give an example of each cost-based and price-based systems.
C. Acute care hospital
a. Identify the cost-based system for each (IPPS, OPPS, etc.)
b. Identify the price-based payment system for each (DRG, APC, etc.)
c. Explain how each unit of payment for each of these price-bases systems works for reimbursement meaning how is payment determined for reimbursement.
D. Long-term care hospital
a. Identify the cost-based system for each (IPPS, OPPS, etc.)
b. Identify the price-based payment system for each (DRG, APC, etc.)
c. Explain how each unit of payment for each of these price-bases systems works for reimbursement meaning how is payment determined for reimbursement.
E. Hospital outpatient
a. Identify the cost-based system for each (IPPS, OPPS, etc.)
b. Identify the price-based payment system for each (DRG, APC, etc.)
c. Explain how each unit of payment for each of these price-bases systems works for reimbursement meaning how is payment determined for reimbursement.
F. Ambulatory surgery center
a. Identify the cost-based system for each (IPPS, OPPS, etc.)
b. Identify the price-based payment system for each (DRG, APC, etc.)
c. Explain how each unit of payment for each of these price-bases systems works for reimbursement meaning how is payment determined for reimbursement.
G. Physician office.
a. Identify the cost-based system for each (IPPS, OPPS, etc.)
b. Identify the price-based payment system for each (DRG, APC, etc.)
c. Explain how each unit of payment for each of these price-bases systems works for reimbursement meaning how is payment determined for reimbursement.