Exam 7: Provider Payment

How will each of the following bases for hospital payment affect the number of admissions, the average length of stay, the volume of services per day, and the unit cost of services (cost per service): Fee-for-service payment Per diem payment Fixed-fee per admission

Under retrospective payment, the entity incurring all financial risk is

The method of payment that is similar to a piece-rate method is

Information symmetry occurs when at least some relevant information for a transaction is known to some, but not all, of the parties involved.

Under the DRG system, assume a conversion rate of $525 per unit and a relative weight of 2.65, then a hospital would receive how much for a patient with this diagnosis?

Medicare's Shared Savings Program establishes financial incentives for Accountable Care Organizations to provide coordinated, well-managed care across all types of providers.

A principal-agent relationship exists when one entity or individual (called the principal) acts on behalf of another entity or individual (called the agent)

The use of the usual, customary and reasonable (UCR) payment method has often been viewed as anti-inflationary.

How does an all-payer system differ from a multi-payer system?

If the marginal cost curve slopes upward steeply, an increase in physicians' fees will bring about

The substitution effect reflects the change in the desired hours of work resulting from a change in income when the wage is held constant.

Define the terms usual, customary, and reasonable as a form of payment.

A Critical Access Hospital is a full-service acute care hospital in a rural area

Under capitation, the healthcare provider is placed at financial risk for all members in his/her panel.

A method of paying hospitals that is based on an amount paid for each day a patient is hospitalized is