A type of reimbursement used by CMS that bases Medicare payments on a predetermined,fixed amount (e.g.,DRGs for inpatient hospital services)is called:
A) capitation.
B) fee-for-service.
C) discounted fee-for-service.
D) prospective payment system.

Question

Quizplus · Accepted Answer

The prospective payment system (PPS) uses a predetermined, fixed amount to determine Medicare payments for services such as inpatient hospital care, home health services, and skilled nursing facilities. This system aims to control healthcare costs by incentivizing healthcare providers to deliver efficient and effective care. Capitation refers to a payment model where healthcare providers receive a fixed amount per patient, regardless of the number or type of services provided. Fee-for-service and discounted fee-for-service both refer to payment models where providers are reimbursed for each service provided, rather than a fixed amount per patient or diagnosis.

A Type of Reimbursement Used by CMS That Bases Medicare