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10 Cards in this Set
- Front
- Back
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three types of payment methods
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cost
fee schedule price-relate |
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fee schedule
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a predetermined rate that is neither related to cost or prices
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price-related
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payment is based on some relationship to charges or "price"
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How healthcare providers control of revenue function
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- set prices in a manner to generate required revenue
- contract negotiation is a criticial acitiviy - coding and billing issues are very important |
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factors of pricing
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- desired net income
- competitive positoin - market structure / share |
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desired net income
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must be able to generate enough revenue through sales of products and services to sustain operations and rpovide for the replacement of assets
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competitive postion
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percieved quality of service will afect an organization's ability to set pricing
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market structure / share
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competition
payor mix capital intensity |
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price setting for health care services
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must set rates at levels sufficient to maintain fincancial viability
- cover average costs - losses on fee schedules payors - write offs on bill charge patients - allowance for profit |
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justifiying health care firm prices
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rising visibilty of health care prices
dramatic increase in hospital prices from 1.6 times cost in 1996 to 2.2 cost in 2004 contributing factors: - uninsured - medicare (aid) losses - managed care payment trends - losses on fee schedule payors |
