Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
11 Cards in this Set
- Front
- Back
|
A method of reimbursing providers (usually physicians) with a fixed payment typically expressed as a per-member-per-month payment that is made in advance for future anticipated contracted health services.
|
Capitation
|
|
|
The federal government agency that administers Medicare and Medicaid. Formerly known as the Health Care Financing Administration (HCFA).
|
Centers for Medicare and Medicaid Services (CMS)
|
|
|
Refers to reimbursement based on a predetermined fixed price per case or diagnosis for clients in 468 categories.
|
DRGs (diagnosis-related roups_
|
|
|
The total output of all goods and services in the country.
|
GDP (gross domestic product)
|
|
|
The federal government agency that administered Medicare and Medicaid until 2001.
|
Health Care Financing Administration (HCFA)
|
|
|
An economic term that refers to the change in some variable (e.g., the number of tests performed).
|
Marginal
|
|
|
A jointly sponsored state and federal program that pays for medical services for persons who are elderly, poor, blind, or disabled and for families with dependent chldren.
|
Medicaid
|
|
|
A federally funded health insurance program for the disabled, persons with end-state renal disease, and persons 65 years of age and older who qualify for social security benefits.
|
Medicare
|
|
|
A method of reimbursing health care proviers (i.e., physicians, hospitals) in which the total amount of payment for care is predetermined based on the patient's diagnosis; provides for a "set price per diagnosis" payment system in contrast to the retrospective or "fee-for-service" system; encourages increased efficiency in the use of health care services since providers are reimbursed at a set level regardless of how any services are rendered or procedures performed to treat a particular diagnostic category; predominant method of payment in today's helath care system
|
Prospective payment system
|
|
|
a method of reimbursing health care prociders (i.e., physicians, hospitals) in which professional services are rendered and charges are billed based on each individual service provided; also known as the "fee-for-service" payment system. This system encourages overuse of health care services because the moreservices rendered or procedures performed, the more revenue received by providers.
|
Retrospective payment system
|
|
|
An organization other than the patient and the supplier (hospital or physician), such as an insurance company, that assumes responsibility for payment of health care charges.
|
Third party
|
