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PPS - Prospective Payment System What is prospective payment system? - Payment for all care delivered during an episode of care based on pre-determined fixed amount (DRGs). Influenced by care setting. What are the 4 types of Prospective Payment Systems? - Capitation, global payment method, case-rate methodology, and bundled payment. Capitation - System of payment used by managed care plans in which physicians and hospitals are paid a fixed, per capita amount for each patient enrolled over a stated period regardless of the type and number of services provided; reimbursement to the hospital on a per-member/per-month basis to cover costs for the members of the plan. (PMPM) Global Payment Method - Third-party payer makes one combined payment to cover the services of multiple providers who are treating a single episode of care. Case-Rate Method - Reimburses provider for all services provided during entire encounter or visit, regardless of length of stay. Based on typical costs of condition, and is usually used in inpatient admissions