Medicare payments to providers are heavily based on drgs


Question: 1. Medicare payments to providers are heavily based on DRGs and APCs today. Explain how DRGs and APCs work, and discuss how they impact hospitals in particular.

2. Explain how to calculate the allowance for doubtful accounts and the bad-debt expense in a hospital.

3. Review Exhibit 5.1, Office of Inspector General Work Plan: Selected Areas for Review in Billing and Claims Processing, Fiscal Year 2013, on pages 156-158 of your textbook, and discuss actions that a healthcare organization can take to eliminate or reduce government penalties under this plan.

4. A key aspect of the Patient Protection and Affordable Care Act is rewarding hospitals for strong performance and penalizing them for quality issues, such as high infection rates and high readmission rates to the facility. Explain the details of how PPACA rewards and punishes hospitals for their performance.

5. Describe what capacity evaluations are, what purpose they serve, who is responsible for performing them, and what role they play in the healthcare system.

6. Describe the legal system's involvement regarding competency decisions and the impact on the healthcare system.

7. Define competency in your own words, and summarize the impact of patient competency on the healthcare system.

8. Summarize the effect of health literacy on the healthcare system and why it is necessary to have a general understanding of the term competency.

The response should be at least 200 words in length for all Questions.

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Dissertation: Medicare payments to providers are heavily based on drgs
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