paying for the hospital

/in /by

Discuss (in about 2-3 pages) the advantage and disadvantage of the following hospital payment systems on cost containment and provider behavior:

  • Fee-for-service
  • Per diem
  • The DRG-based payment system (i.e., Medicare’s Inpatient Prospective Payment System)
  • Capitation

Part II – Paying for Physician Services

Using the background materials and the information you find from the literature and on the Internet, respond (in about 2-3 pages) to the following questions:

  1. Discuss the difference in Medicare payment methods for outpatient services and physician services.
  2. Discuss the difference between bundled payments and global payments.

SLP Assignment Expectations

Length: Write a 2- to 3-page paper, typed and double spaced, with 12 pt. Times New Roman font and 1-inch page margins. Use headers throughout the paper. This will aid you in not overlooking vital elements of the assignment and make the document easier for the reader to follow.

Medicare Payment Advisory Commission. (2016). Medicare Payment Basics:
Hospital Acute Inpatient Services Payment System. Available at: http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_hospital_final.pdf

Medicare Payment Advisory Commission. (2014). Medicare Payment Basics: Outpatient Hospital Services Payment System. Available at http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_opd_final.pdf?sfvrsn=0

Centers for Medicare and Medicaid. (2010). Hospital Outpatient Prospective Payment System. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at http://www.cms.gov/MLNProducts/downloads/HospitalOutpaysysfctsht.pdf (Retrieved 11/21/2012)

Centers for Medicare and Medicaid. (2009). Acute Care Hospital Inpatient Prospective Payment System. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at http://www.cms.gov/MLNProducts/downloads/AcutePaymtSysfctsht.pdf (Retrieved 11/21/2012)

Medicare Payment Advisory Commission. (2014). Physician and Other Health Professionals Payment System. Available at http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_16_physician_final.pdf?sfvrsn=0

Centers for Medicare and Medicaid. (2014). Medicare Physician Fee Schedule. The Medicare Learning Network Payment Systems Fact Sheet Series. Available at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedcrephysFeeSchedfctsht.pdf

Guterman, S., Davis, K., Stremikis, K., & Drake, H. (2010). Innovation in Medicare and Medicaid Will Be Central to Health Reform’s Success. Health Affairs, 29 (6), 1188-93. Retrieved from ProQuest on 11/21/2012.

Lesser, C., Fineberg, H., & Cassel, C. (2010). Physician Payment Reform: Principles That Should Shape It. Health Affairs, 29 (5), 948-952. Retrieved from ProQuest on 11/21/2012.

Wilensky, G. (2009). Reforming Medicare’s Physician Payment System. New England Journal of Medicine, 360 (7), 653-655. This item is available in full text via the University library.

 
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