1. Which statement is FALSE about the Conclusion section?
Many people believe that the ACO payment model is an intermediate state on the way to true global capitation.
Private insurers, Medicare, and Medicaid are replacing fee-for-service payment with more aggregated payment mechanisms to shift risk away from payers towards physicians and hospitals.
Payers are trying to find the right balance between economic incentives for overtreatment and undertreatment.
The US HHSS has the goal that 90% of Medicare payments occurring through bundled payments and ACO models by 2018.
Payment levels are increasingly determined by negotiation between payers and providers or by fee schedules set by payers.
2. Which statement is FALSE about the methods of hospital payment?
With capitation payment, hospitals are at risk for admissions, the length of stay, and the resources used.
In the past, insurance companies made fee-for-service payments to private hospitals based on the principle of "reasonable cost."
With DGR, Medicare is at risk with the number of admissions.
In per diem, the insurer is at risk for the number of services performed on any given day.