Payment system

the Prospective Payment System (PPS), fundamentally changed how the government reimburses hospitals for medical services that are covered by Medicare (Davis & Rhodes, 1988). The PPS changed reimbursement from a program where hospitals were reimbursed based on actual expenditures, to the PPS where hospitals were reimbursed a predetermined rate based on the patients Diagnosis Related Group (DRG). For example, Medicare would reimburse a hospital X amount of dollars for a patient discharged from the hospital with a primary diagnosis of pneumonia, regardless of patient length of stay, costs incurred, and complications. The federal government viewed this move as a way to “encourage hospitals to restrain the use of resources while providing high-quality inpatient care” (Davis & Rhodes, 1988, p. 117). DRGs are groups of diagnosis’s that require similar amounts of hospital resources. Shi & Singh state: The primary factor governing the amount of reimbursement is the type of case (a DRG classification), but additional factors can create differences in reimbursement for the same DRG. DRG based rates are adjusted for geographic differences…whether or not the institution is a teaching hospital,…and whether a hospital treats a disproportionate share of low-income patients… The use of PPS allowed Medicare to reign in skyrocketing healthcare costs, and promote quality improvements. Soon other payers saw the cost savings associated with PPS and adopted it into their payment structure.…

Electronic Payment System (EPS) in the business. Touch ‘n Go Sdn Bhd provides a made of payment via a prepaid e-payment smart card called the Touch ’n Go card. The Touch ‘n Go card is an electronic purse that used to pay for toll usage at all highways in Malaysia. Touch ‘n Go Sdn Bhd uses contactless smartcard technology. The credit card-sized Touch ‘n Go smart card is made of plastic with Philips’MIFARE microchip technology (which is locally developed according to Mifare standard, the industry…

studies. This paper looks at Lincoln’s management system and the unique culture it has created for their United States operations. The reader should note, that many of the topics discussed herein do not apply to Lincoln’s foreign…

Medicare pays for the inpatient acute-care services. These payments are based on rate per discharge and by using the Medicare Severity Diagnosis Related Group (MS-DRG) which are assigned to the patients. The MS-DRG is the system by which the Medicare patient’s hospital stay has been classified into different groups in order to make the payments for the services. The MS-DRG assigns code such as 190 stands for chronic obstructive pulmonary disease with MCC. The codes are distributed on the basis…

It is important for healthcare organizations to understand that in order to have a successful program, specific activities need to be implemented to ensure the overall objectives will be achieved. In other words, the activities represent tasks the organizations will perform for the length of the program in order to reach their long-term goal. Therefore, within Gastroenterology Associates, the President and practice manager are teaming up in order to implement an educational program based on the…

What is it? Bitcoin is a newer type of payment system everything is completely digital. The forms of money are digital also like PayPal, but Bitcoin cannot be traced. Everything is powered by the users there is no business or authority to control or monitor it. Users look at bitcoins as like money for the internet domain. Who invented Bitcoin? When Bitcoin was first created, it was known as a cryptocurrency. Bitcoin was developed and published for use in 2009 by Satoshi Nakamoto. Since 2010…

Defining the Market The four major purchase transactions worldwide in the consumer payment industry are done by Visa, MasterCard, Union Play and Amex. In 2014, together Visa and MasterCard represented about 84% of the market share (Visa with about 58% and MasterCard about 26% of the market share) (see appendix I). In the Notably, Visa and MasterCard are set up as a cooperatives of banks. According to mainstream economics, when firms instead of competing decides to collude. They may jointly…

MACRA tried to align various previous performances programs, consolidating aspects of the PQRS, Value-Based Payment Modifier Program, and the Meaningful Use initiatives. MACRA defines two approaches of payment to enable the change towards the goal of paying for better care value; Alternative Payment Models (APMs), and the Merit-Based Incentives Payment System (MIPS). APMs offers novel alternatives to pay health care providers for the care they give Medicare beneficiaries and incorporate…

Since this research paper is going to illustrate the different payment mechanisms in public-private partnerships projects, it is useful to start briefly with some definitions of P3 term. Indeed, P3 can be defined as a long-term contract to provide a public service or maintain a public facility, such as highways, hospitals, and bridges, between the private sector and the government entity . In this contract, the private sector will be taking the risk and the responsibility to maintain, operate,…

Introduction One thing that is consistent in healthcare is that healthcare is forever evolving. With the concept of evolution one particular area that plays a major role in how healthcare system evolves is revenue and the other is how the healthcare facilities get payment for the services provided. When exploring healthcare services reimbursement there are checks and balances that must take place. The healthcare provider orders services such as radiology and laboratory services just to name a…