Exam (elaborations)
Nurse Executive Business Management with 100- correct answers.
- Course
- Institution
Nurse Executive Business Management with 100- correct answers.
[Show more]
Content preview
Nurse Executive:Business
Management
with 100%
correct answers
Self-Pay
the individual pays out-of-pocket for care, usually
at non-discounted prices.
Charity Care
Services for which healthcare organizations did not
expect payment because they had previously
determined the patients' or clients' inability to pay.
Health Maintenance Organization (HMO)
provides health care on capitation basis with
members paying set fees to receive all services
Prospective Payment System (PPS)
,Payment according to the specific type of patient
Preferred Provider Organization (PPO)
healthcare services provided to a group of
individuals based on a negotiated fee. Patients
must usually choose physicians within a network to
avoid increased costs
Point-of-service organization (PSO)
Members can receive lower cost coverage if using
in-network providers or may pay more to use out-
of-network providers.
Medicare/Medicaid
includes different options, such as pay-for
performance, prospective payment, PPO, and HMO.
Payment Bundling
a method of reimbursement in which all healthcare
providers engage in an episode of care are
reimbursed through one payment rather than
billing separately for services so that the group is
essentially responsible for the patient rather than
the individual. 4 models being tested.
Payment Bundling: Model 1
Bundling programretrospective acute care hospital
stay only. Payment made for acute hospital care
only
, Payment Bundling: Model 2
Bundling programretrospective acute care hospital
stay plus post acute care: payment for acute care
and related services after DC for 30, 60, 90 days
Payment Bundling: Model 3
Bundling programretrospective post acute care
only: payment for post acute services beginning
within 30 days of hospitalization and ending at 30,
60, 90 days post discharge
Payment Bundling: Model 4
Bundling programAcute care hospital stay only:
payment covers hospitalization, physician care and
other practitioners care. The hospital pays MD and
others out of the bundled payment.
Inpatient Prospective Payment System (IPPS)
Hospitals who receive this type of reimbursement
must complete at least 300 HCAHPS surveys over
four calendar quarters a year.
Pay for Performance (P4P)
performance-oriented incentives for hospitals and
physicians to improve the quality of patient
healthcare
Pay for Performance quality measures
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller BRAINBOOSTERS. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $18.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now