Deck 7: Provider Payment

Question 1

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

A) Salary
B) Capitation
C) Per case
D) Fee for service

Answer 1

D

Question 2

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

A) A large increase in physician supply
B) No change in physician supply
C) A small increase in physician supply
D) An indeterminate amount of change in physician supply

Answer 2

C

Question 3

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

A) Per diem payment
B) Per service payment
C) Per admission payment
D) Per patient panel

Answer 3

A

Question 4

Under retrospective payment, the entity incurring all financial risk is

A) The hospital
B) The patient
C) The payer
D) The employer

Question 5

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?

A) $198.11
B) $1391.25
C) $2782.50
D) $525.00

Question 6

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

Question 7

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

Question 8

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

Question 9

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

Question 10

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

Question 11

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

Question 12

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

Question 13

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

Question 14

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

Question 15

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