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Economics
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Feb 20, 2024
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HIM2729C
HIT 230 Module 6-10
1.
Which of the following concepts is a guiding principle for prospective payment?
Payment rates are established in advance of the healthcare delivery and are fixed for the fiscal period to which they apply.
[There are 4 guiding principles of prospective payment: See pg 115
Payment rates are to be established in advance and fixed for the fiscal period to which they apply
-Payment rates are not automatically determined by the hospital's past or current actual cost.
Prospective payment rates are considered to be payment in full.
The hospital retains the profit or suffers a loss resulting from the difference between the payment rate and the hospital's cost, creating an incentive for cost control.]
2.
Which piece of legislation called for the first hospital inpatient prospective payment system? This
piece of legislation also allowed some hospital setting to retain their cost-based payment systems.
-Tax Equity and Fiscal Responsibility Act (TEFRA)
[The TEFRA of 1982 mandated extensive changes to the Medicare program, and called for the implementation of a PPS for hospital inpatients.]
3.
What is the average of the sum of the relative weights of all patients treated during a specified time period?
-Case mix index
[The cas mix indes is a weighted average of the sum of the relative weights of all patients treated
during a specified time period.]
4.
Which is the correct formula for IPF wage index adjustment?
-(federal payment rate labor portion WI) + (federal payment rate * non-labor portion)
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