answer the questions 196

It is healthcare management class, I attached the text in case you need it

Please answer the following questions regarding reimbursement and payment systems. The supplementary reading 5th Edition Primer on Hospital Accounting will be extremely helpful. In addition you may have to do some outside research to get all of the answers.

A Primer on Hospital Accounting and Finance%2c 5th Edition.pdf

Please write out each question and place the answer underneath. Your responses should be typed in a reasonable font, double spaced.

  1. What is a DRG?
  2. How are DRG’s used to pay for Medicare services?
  3. How does DRG reimbursement differ from per diem reimbursement?
  4. What is percentage of charges reimbursement?
  5. What is reimbursement based on capitation?
  6. What is a contractual allowance? Do hospitals ever get paid for contractual allowances?
  7. Does Medicare supplemental insurance increase the total amount that is due and payable to a hospital or just change who pays it? Explain your answer.
  8. Contrast the length of stay incentive to the hospital in DRG reimbursement vs. per diem reimbursement vs. capitation.
  9. Why do think that DRG reimbursement may put physicians and hospitals at odds based on economics?
  10. From a hospital’s point of view, what is the volume metric that will maximize reimbursement under each scenario:(1) under DRG reimbursement; (2) under per diem reimbursement; and (3) under capitation? (Hint: Each reimbursement method has a different controlling volume metric.
    Most of these questions can be answered in as little as two or three sentences.

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